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Factors predictive of occult nipple-areolar complex involvement in patients with carcinoma in situ of the breast

Authors
 Hyeoseong Hwang  ;  Seho Park  ;  Ja Seung Koo  ;  Hyung Seok Park  ;  Seung Il Kim  ;  Young Up Cho  ;  Byeong‐Woo Park  ;  Jung Hyun Yoon  ;  Min Jung Kim  ;  Eun‐Kyung Kim 
Citation
 Journal of Surgical Oncology, Vol.116(8) : 1046-1055, 2017 
Journal Title
 Journal of Surgical Oncology 
ISSN
 0022-4790 
Issue Date
2017
MeSH
Adult ; Aged ; Breast Carcinoma In Situ/diagnostic imaging ; Breast Carcinoma In Situ/pathology* ; Breast Carcinoma In Situ/surgery ; Breast Neoplasms/diagnostic imaging* ; Breast Neoplasms/pathology* ; Breast Neoplasms/surgery ; Carcinoma, Intraductal, Noninfiltrating/pathology ; Female ; Humans ; Logistic Models ; Magnetic Resonance Imaging ; Middle Aged ; Nipples/pathology* ; Nipples/surgery ; Retrospective Studies
Keywords
breast neoplasms ; carcinoma in situ ; magnetic resonance imaging ; nipples ; risk factors
Abstract
OBJECTIVES: To investigate predictors of occult nipple-areolar complex (NAC) involvement in patients with carcinoma in situ (CIS) and to validate an online probability calculator (CancerMath; www.lifemath.net/cancer/breastcancer/nipplecalc/index.php). METHODS: Mastectomized patients with CIS (n = 104) were retrospectively selected. Clinicopathology and preoperative mammography, ultrasound, and magnetic resonance imaging (MRI) findings were analyzed. RESULTS: Histopathological NAC-positivity was confirmed in 20 (19.2%) patients. Short nipple-tumor distance and suspicious extension to the nipple by mammography were significant but ultrasound was not significant to predict NAC involvement. NAC-positive cases had MRI findings of shorter nipple-tumor distance in both the early and delayed phases. Multivariable regression model showed age >50 years and shorter tumor-nipple distance on the delay phase of MRI were statistically significant predictors of NAC involvement. Area under the receiver operating characteristics curve (AUC) was 0.618 when calculated by CancerMath; however, an AUC of 0.954 was achieved when distance and age were applied together as predictor. CONCLUSIONS: Mammographic and MRI findings were significant for predicting NAC involvement, with distance of the tumor from the nipple in delay phase MRI the most significant predictor of NAC involvement. Therefore, breast MRI could be beneficial for planning nipple-sparing mastectomy in patients with CIS.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161661
DOI
10.1002/jso.24768
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
구자승(Koo, Ja Seung) ; 김민정(Kim, Min Jung) ; 김승일(Kim, Seung Il) ; 김은경(Kim, Eun-Kyung) ; 박병우(Park, Byeong Woo) ; 박세호(Park, Se Ho) ; 박형석(Park, Hyung Seok) ; 윤정현(Yoon, Jung Hyun) ; 조영업(Cho, Young Up) ; 황혜성(Hwang, Hyeoseong)
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Full Text
https://onlinelibrary.wiley.com/doi/abs/10.1002/jso.24768
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