Breast-conserving Surgery with Partial Resection of the Nipple and Areola —Our Experience of 29 Cases

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 81; no. 12; pp. 2411 - 2417
• Main Authors: OGAWA, Akio, ITO, Yuko, NOJIRI, Motoi
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2020
• Subjects: breast-conserving surgery; intraductal growth; partial resection of the nipple and areola
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.81.2411

Objective : Breast-conserving surgery with partial resection of the nipple and areola was performed in patients with early-stage breast cancer with suspected intraductal growth in the intrapapillary duct and subareolar region. We investigated the curability and safety of this approach.Methods : Preoperative breast magnetic resonance imaging (MRI, 3.0 T) was performed to evaluate intraductal growth. We investigated 29 consecutive patients who underwent this procedure between May 2015 and December 2019.Results : The mean age of patients was 58.5 years. The primary focus was detected in the nipple-areolar and other areas in 10 and 19 patients, respectively. Preoperative breast MRI revealed Tis in nine, T1 in 15, and T2 in five patients. Of the 10 patients in whom intraductal growth was detected on preoperative breast MRI, the intrapapillary duct was thickened and clearly visualized in all four patients who were accurately diagnosed following postoperative histopathological evaluation. Among 29 patients, postoperative histopathological evaluation showed intraductal growth outside the areola in only one patient. Postoperative histopathological evaluation showed a positive surgical margin in two patients with a positive lateral margin on the nipple side ; one patient showed a positive deep margin and the other showed a positive lateral margin. All cancer-positive specimens were positive only for intraductal cancer.Conclusion : Positive lateral margins on the side of the nipple were observed in only 2 patients who underwent this surgical procedure ; both patients showed intraductal involvement. Therefore, we conclude that this surgical procedure would be feasible with regard to safety and curability.