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Significance of Non-Mass Enhancement in the Subareolar Region on Preoperative Breast Magnetic Resonance Imaging for Nipple-Sparing Mastectomy

Authors
 Shiyeol Jun  ;  Soong June Bae  ;  Yoon Jin Cha  ;  Chihwan Cha  ;  Soeun Park  ;  Dooreh Kim  ;  Janghee Lee  ;  Sung Gwe Ahn  ;  Eon Ju Son  ;  Joon Jeong 
Citation
 CLINICAL BREAST CANCER, Vol.20(4) : e458-e468, 2020-08 
Journal Title
 CLINICAL BREAST CANCER 
ISSN
 1526-8209 
Issue Date
2020-08
Keywords
breast neoplasms ; magnetic resonance imaging ; mastectomy ; nipple ; radiographic image enhancement
Abstract
Purpose: The eligibility for nipple-sparing mastectomy (NSM) regarding subareolar non-mass enhancement (NME) on breast magnetic resonance imaging (MRI) was not clear. This study aimed to evaluate the eligibility for NSM according to the NME-to-nipple distance on preoperative breast MRI. Methods: We identified patients with breast cancer who underwent mastectomy with NME suspected of malignancy in the subareolar region on preoperative breast MRI. The incidence of nipple invasion was pathologically evaluated according to the NME-to-nipple distance on breast MRI, and the clinicopathologic factors related to pathologic nipple invasion were analyzed. Results: Of 137 patients, 55 (40.1%) had NME extension to the nipple, 53 (38.7%) had radiologic distance less than 2 cm, and 29 (21.2%) had radiologic distance of 2 cm or more. The rate of pathologic nipple invasion was 52.7% (29 of 55) in patients with NME extension to nipple, 7.5% (4 of 53) in patients with NME-to-nipple distance less than 2 cm, and 3.4% (1 of 29) in patients with NME-to-nipple distance of 2 cm or more (P < .001). NME extension to the nipple was an independent risk factor for pathologic nipple invasion (odds ratio 21.702; 95% confidence interval, 2.613-180.225; P = .004). The survival outcome was not different between NSM and conventional total mastectomy/skin-sparing mastectomy in patients with radiologic distance less than 2 cm, but without NME extension to the nipple. Conclusions: NSM is an acceptable procedure in patients with breast cancer with a low incidence of pathologic nipple invasion when there is no evidence of NME extension to the nipple on preoperative breast MRI.
Full Text
https://www.sciencedirect.com/science/article/pii/S1526820920300409
DOI
10.1016/j.clbc.2020.02.005
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Bae, Soong June(배숭준) ORCID logo https://orcid.org/0000-0002-0012-9694
Son, Eun Ju(손은주) ORCID logo https://orcid.org/0000-0002-7895-0335
Ahn, Sung Gwe(안성귀) ORCID logo https://orcid.org/0000-0002-8778-9686
Jun, Shiyeol(전시열)
Jeong, Joon(정준) ORCID logo https://orcid.org/0000-0003-0397-0005
Cha, Yoon Jin(차윤진) ORCID logo https://orcid.org/0000-0002-5967-4064
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180455
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