Local control by breast-conserving surgery with nipple resection.

Area of Science:

• Oncology
• Surgical Oncology
• Breast Cancer Research

Background:

• Breast-conserving therapy (BCT) is a standard treatment for early breast cancer.
• Nipple involvement or proximity of tumors to the nipple presents a surgical challenge in BCT.
• The oncologic safety and efficacy of nipple resection in BCT remain an area of investigation.

Purpose of the Study:

• To compare local control rates between breast-conserving surgery with nipple resection (BCT-NR) and standard breast-conserving surgery without nipple resection (BCT).
• To evaluate the impact of nipple resection on oncologic outcomes in early breast cancer patients undergoing BCT.

Main Methods:

• Retrospective analysis of 333 early breast cancer patients treated with BCT between 1991 and 2002.
• Patients were divided into two groups: BCT (n=320) and BCT with nipple resection (BCT-NR, n=13).
• All patients received wide local excision with a minimum 2-cm margin and radiation therapy. Tumor location relative to the nipple was the primary determinant for nipple resection.

Main Results:

• No significant differences were observed in patient demographics, tumor characteristics, or surgical margin status between the BCT and BCT-NR groups.
• Positive surgical margins occurred in 17.2% of the BCT group versus 7.7% in the BCT-NR group.
• Breast-free survival rates were comparable between the two treatment groups, indicating similar local control.

Conclusions:

• Breast-conserving surgery with nipple resection and radiation therapy is a viable option for early breast cancer patients with tumors located under or very close to the nipple.
• BCT-NR demonstrated comparable local control to standard BCT, suggesting it can be safely employed in select cases.
• Nipple resection in BCT may be considered to achieve adequate margins and maintain oncologic safety when indicated by tumor location.