Management of positive sub-areolar/Nipple duct margins in nipple-sparing mastectomies

Melissa S. Camp; Suzanne B. Coopey; Rong Tang; Amy Colwell; Michelle Specht; Rachel A. Greenup; Michele A. Gadd; Elena Brachtel; William G. Austen; Barbara L. Smith

doi:10.1111/tbj.12279

Management of positive sub-areolar/Nipple duct margins in nipple-sparing mastectomies

Melissa S. Camp, Suzanne B. Coopey, Rong Tang, Amy Colwell, Michelle Specht, Rachel A. Greenup, Michele A. Gadd, Elena Brachtel, William G. Austen, Barbara L. Smith

Research output: Contribution to journal › Article › peer-review

19 Scopus citations

Abstract

We evaluated management of positive sub-areolar/nipple duct margins in nipple-sparing mastectomies (NSM) at our institution. Retrospective chart review of all NSM from January 2007 to April 2012 was performed and patient, tumor, and treatment information was collected. Sub-areolar/nipple duct margins included ductal tissue from within the nipple. Of 438 NSM, 22 (5%) had positive sub-areolar/nipple duct margins; 21 of 220 cancer-bearing breasts (10%) and 1 of 218 prophylactic mastectomies (0.5%). Positive margins included four with invasive lobular carcinoma and 18 with ductal carcinoma in situ (DCIS). Management included removal of eight nipples and nine nipple areola complexes (NAC). Four of 17 nipple/NAC specimens had evidence of residual DCIS and none had residual invasive cancer. The majority of nipple/NAC specimens excised for a positive margin had no residual malignancy. Future studies are needed to determine the extent of NAC tissue removal required for positive margins.

Original language	English (US)
Pages (from-to)	402-407
Number of pages	6
Journal	Breast Journal
Volume	20
Issue number	4
DOIs	https://doi.org/10.1111/tbj.12279
State	Published - 2014
Externally published	Yes

Keywords

nipple
nipple areola complex
nipple-sparing mastectomy
sub-areolar margin

ASJC Scopus subject areas

Internal Medicine
Surgery
Oncology

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10.1111/tbj.12279

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title = "Management of positive sub-areolar/Nipple duct margins in nipple-sparing mastectomies",

abstract = "We evaluated management of positive sub-areolar/nipple duct margins in nipple-sparing mastectomies (NSM) at our institution. Retrospective chart review of all NSM from January 2007 to April 2012 was performed and patient, tumor, and treatment information was collected. Sub-areolar/nipple duct margins included ductal tissue from within the nipple. Of 438 NSM, 22 (5%) had positive sub-areolar/nipple duct margins; 21 of 220 cancer-bearing breasts (10%) and 1 of 218 prophylactic mastectomies (0.5%). Positive margins included four with invasive lobular carcinoma and 18 with ductal carcinoma in situ (DCIS). Management included removal of eight nipples and nine nipple areola complexes (NAC). Four of 17 nipple/NAC specimens had evidence of residual DCIS and none had residual invasive cancer. The majority of nipple/NAC specimens excised for a positive margin had no residual malignancy. Future studies are needed to determine the extent of NAC tissue removal required for positive margins.",

keywords = "nipple, nipple areola complex, nipple-sparing mastectomy, sub-areolar margin",

author = "Camp, {Melissa S.} and Coopey, {Suzanne B.} and Rong Tang and Amy Colwell and Michelle Specht and Greenup, {Rachel A.} and Gadd, {Michele A.} and Elena Brachtel and Austen, {William G.} and Smith, {Barbara L.}",

year = "2014",

doi = "10.1111/tbj.12279",

language = "English (US)",

volume = "20",

pages = "402--407",

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AU - Camp, Melissa S.

AU - Coopey, Suzanne B.

AU - Tang, Rong

AU - Colwell, Amy

AU - Specht, Michelle

AU - Greenup, Rachel A.

AU - Gadd, Michele A.

AU - Brachtel, Elena

AU - Austen, William G.

AU - Smith, Barbara L.

PY - 2014

Y1 - 2014

N2 - We evaluated management of positive sub-areolar/nipple duct margins in nipple-sparing mastectomies (NSM) at our institution. Retrospective chart review of all NSM from January 2007 to April 2012 was performed and patient, tumor, and treatment information was collected. Sub-areolar/nipple duct margins included ductal tissue from within the nipple. Of 438 NSM, 22 (5%) had positive sub-areolar/nipple duct margins; 21 of 220 cancer-bearing breasts (10%) and 1 of 218 prophylactic mastectomies (0.5%). Positive margins included four with invasive lobular carcinoma and 18 with ductal carcinoma in situ (DCIS). Management included removal of eight nipples and nine nipple areola complexes (NAC). Four of 17 nipple/NAC specimens had evidence of residual DCIS and none had residual invasive cancer. The majority of nipple/NAC specimens excised for a positive margin had no residual malignancy. Future studies are needed to determine the extent of NAC tissue removal required for positive margins.

AB - We evaluated management of positive sub-areolar/nipple duct margins in nipple-sparing mastectomies (NSM) at our institution. Retrospective chart review of all NSM from January 2007 to April 2012 was performed and patient, tumor, and treatment information was collected. Sub-areolar/nipple duct margins included ductal tissue from within the nipple. Of 438 NSM, 22 (5%) had positive sub-areolar/nipple duct margins; 21 of 220 cancer-bearing breasts (10%) and 1 of 218 prophylactic mastectomies (0.5%). Positive margins included four with invasive lobular carcinoma and 18 with ductal carcinoma in situ (DCIS). Management included removal of eight nipples and nine nipple areola complexes (NAC). Four of 17 nipple/NAC specimens had evidence of residual DCIS and none had residual invasive cancer. The majority of nipple/NAC specimens excised for a positive margin had no residual malignancy. Future studies are needed to determine the extent of NAC tissue removal required for positive margins.

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KW - nipple-sparing mastectomy

KW - sub-areolar margin

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Management of positive sub-areolar/Nipple duct margins in nipple-sparing mastectomies

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Keywords

ASJC Scopus subject areas

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