Screening the nipple for involvement in breast cancer

Area of Science:

• Oncology
• Surgical Pathology

Background:

• Neoplastic involvement of the nipple-areolar complex (NAC) is a critical factor in breast cancer management.
• Accurate risk stratification for NAC involvement is essential for guiding treatment decisions and patient counseling.

Purpose of the Study:

• To evaluate the efficacy of combined clinical and pathological criteria in classifying mastectomy patients into high-risk and low-risk groups for neoplastic involvement of the nipple-areolar complex.
• To determine the incidence of nipple involvement in each risk group.

Main Methods:

• Independent clinical and pathological screens were developed based on specific criteria.
• Clinical criteria included nipple signs, cutaneous signs, tumor location, size, and bilaterality.
• Pathological criteria included subareolar involvement, multicentricity, and nodal involvement.

Main Results:

• Fifty consecutive mastectomy patients were classified into high-risk (46%) and low-risk (54%) groups.
• The low-risk group exhibited 0% incidence of nipple involvement.
• The high-risk group demonstrated a 35% incidence of neoplastic nipple involvement, with all involved nipples falling into this category.

Conclusions:

• Clinical and pathological screening criteria effectively stratify mastectomy patients into distinct risk groups for nipple-areolar complex involvement.
• This classification system can accurately identify patients with a high likelihood of neoplastic nipple involvement, informing surgical and adjuvant treatment strategies.