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Parameters that predict nipple involvement in breast cancer.
P A Lambert1, P Kolm, R R Perry
1Department of Surgery, Eastern Virginia Medical School, Norfolk 23507, USA.
Journal of the American College of Surgeons
|October 13, 2000
Summary
Breast-conserving surgery survival rates match mastectomy. Larger, central tumors and higher stage increase nipple involvement risk, impacting treatment decisions for breast cancer patients.
Area of Science:
- Oncology
- Surgical Oncology
- Breast Cancer Research
Background:
- Breast conservation therapy (BCT) offers survival rates comparable to modified radical mastectomy.
- Nipple involvement in BCT can lead to incomplete tumor excision and recurrence.
Purpose of the Study:
- To identify clinical and tumor parameters predicting cancerous nipple involvement in breast cancer patients.
- To aid in selecting appropriate candidates for nipple preservation during BCT.
Main Methods:
- Retrospective review of 803 breast cancer patients' records (1990-1995).
- Analysis of ten parameters: age, race, tumor location, histologic grade, tumor size, nodal involvement, TNM stage, ER status, DNA ploidy, and S-phase.
- Patients categorized into nipple-positive, nipple-negative, and nipple-not-removed groups.
Main Results:
- Overall nipple positivity rate was 12%.
- Significant predictors in univariate analysis included pathologic stage, tumor size, lymph node status, histologic grade, and tumor location.
- Multivariable analysis identified advanced stage (≥3), central/overlap tumor location, and high histologic grade (3/undifferentiated) as key predictors of nipple involvement.
Conclusions:
- Nipple preservation decisions in BCT are challenging for larger, centrally located tumors.
- A multivariable model can help predict nipple involvement risk, guiding patient selection for nipple preservation.