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Tumor-to-nipple Distance Should Not Preclude Nipple-sparing Mastectomy in Breast Cancer Patients. Personal Experience and Literature Review

2020; International Institute of Anticancer Research (IIAR) Conferences 1997. Athens, Greece. Abstracts; Volume: 40; Issue: 6 Linguagem: Inglês

10.21873/anticanres.14343

1791-7530

Piero Fregatti, Marco Gipponi, Gabriele Zoppoli, Matteo Lambertini, Eva Blondeaux, Liliana Belgioia, Raffaele De Rosa, Federica Murelli, Francesca Depaoli, Marcello Ceppi, Alessandro Garlaschi, Daniele Friedman,

Breast Lesions and Carcinomas

Background/Aim: A retrospective study was performed in 246 breast cancer patients to define whether tumor-to-nipple distance (TND) assessment by breast MRI may select patients eligible to nipple-sparing mastectomy (NSM) as compared to permanent section assessment of retroareolar margin. Patients and Methods: Pre- and post-operative parameters including imaging data, histology of the primary tumor, biologic prognostic factors, and adjuvant regimens were retrieved; patients with close/positive retroareolar margins underwent nipple or NAC excision. The primary endpoint was loco-regional recurrence (LRR). Results: Patients with TND ≤2 cm had a significantly higher rate of invasive ductal carcinoma (p<0.003) and excision margins less than 2 mm (p<0.000). Eleven retroareolar specimens were positive at definitive pathology; final re-excision specimen examination showed residual disease in seven patients (63.6%). At a median follow-up of 31 to 33 months, no NAC recurrence did occur; disease-free survival was more than 96%, and LRR was homogeneously distributed among TND subgroups. Conclusion: Therapeutic NSM is a safe procedure independently of TND assessed at preoperative breast MRI. Permanent section assessment of retroareolar tissue is more accurate and cost-effective than frozen section. Furthermore, delayed nipple and/or NAC excision did not impair local disease control.