Treatment of intraductal breast cancer--noncomedo type

The treatment of intraductal breast carcinoma, ranging from local incision alone to modified radical mastectomy, remains controversial. Seventy-nine patients were treated for intraductal breast carcinoma, noncomedo type at our institution from 1975 to 1991. There were 78 females and one male with a mean age of 58 years and a range from 32 to 90 years. Clinical presentation included a palpable mass in 25 patients, abnormal mammogram in 60 patients, and nipple discharge in 12 patients. Treatment consisted of local excision in 19 patients, simple mastectomy in 25 patients, and modified radical mastectomy in 35 patients. Twenty-five patients underwent simultaneous prophylactic contralateral mastectomy. Choice of treatment was determined by physician preference and no differences were seen in family history, parity, nipple discharge, history of fibrocystic disease, presence of palpable lymph nodes, tumor size, tumor location, patient age, or mammographic findings. Forty-five patients had multicentric tumors on final pathology. One patient demonstrated an axillary lymph node metastasis following modified radical mastectomy raising the question of undetected invasive carcinoma. All patients were free of disease at last evaluation and no differences in survival were noted between different treatment groups with a mean follow up of 5 years. We conclude that local excision is an appropriate option for treatment of intraductal breast carcinoma noncomedo type.