Breast conservation surgery using nipple-areolar resection for central breast cancers

Area of Science:

• Oncology
• Surgical Oncology
• Breast Cancer Surgery

Background:

• Breast conservation surgery (BCS) is a standard treatment for breast cancer.
• Traditionally, central breast cancers involving the nipple-areolar complex (NAC) were excluded from BCS.
• Nipple-areolar complex resection (NACR) is a surgical option for specific central breast cancers.

Purpose of the Study:

• To evaluate the oncologic safety and cosmetic outcomes of NACR for central breast cancers involving the NAC.
• To determine if BCS indications can be safely extended to include these cases.
• To assess recurrence rates and survival following NACR and radiation therapy.

Main Methods:

• Retrospective review of 15 patients (aged 46-88) who underwent NACR for central breast cancers involving the NAC.
• Interventions included NAC resection and postoperative radiation therapy.
• Outcomes assessed via patient questionnaires and medical record review, focusing on recurrence, survival, and cosmesis.

Main Results:

• 15 patients with central breast cancers involving the NAC (10 subareolar, 5 Paget disease) underwent NACR.
• Average tumor size was 1.6 cm.
• With a mean follow-up of 32 months, only 1 recurrence (7%) was observed, with all patients alive and disease-free. Cosmetic results were satisfactory to excellent.

Conclusions:

• NACR is a safe and effective oncologic procedure for central breast cancers involving the NAC.
• This approach extends BCS indications, offering good cosmetic outcomes and low recurrence rates.
• NACR is a viable option for central subareolar cancers and Paget disease of the nipple.