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Subareolar breast cancers.
C Gajdos1, P I Tartter, I J Bleiweiss
1Department of Surgery, Mount Sinai Medical Center, New York, New York, USA.
American Journal of Surgery
|November 21, 2000
Summary
Breast-conserving surgery for subareolar cancers is feasible with radiation therapy. Clinical nipple-areola complex involvement predicts local recurrence risk in breast conservation patients without radiation.
Area of Science:
- Oncology
- Surgical Oncology
- Breast Cancer Research
Background:
- Subareolar cancers frequently involve the nipple-areola complex (NAC), leading to poor cosmetic outcomes with lumpectomy.
- Breast conservation surgery (BCS) is increasingly applied to these cases.
Purpose of the Study:
- To evaluate the outcomes of BCS for subareolar cancers.
- To identify factors predicting recurrence in patients with subareolar cancers.
Main Methods:
- Retrospective review of 95 patients with subareolar cancers treated between 1979 and 1998.
- Analysis of pathologic findings, treatment modalities (mastectomy vs. BCS), and oncologic outcomes.
- Univariate and multivariate analyses to determine predictors of NAC involvement and recurrence.
Main Results:
- Clinical NAC involvement, presentation, and tumor size were associated with pathologic NAC involvement.
- In multivariate analysis, only clinical NAC involvement predicted pathologic NAC involvement.
- For BCS patients, radiation therapy, clinical, and pathologic NAC involvement predicted local recurrence.
- Clinical NAC involvement was the sole predictor of local recurrence in BCS patients after accounting for radiation therapy.
Conclusions:
- Subareolar cancers can be treated with BCS if adjuvant radiation therapy is administered.
- Clinical NAC involvement is a significant risk factor for local recurrence in BCS patients not receiving radiation.