Pathological Evaluation of Nipple-Sparing Mastectomies with Emphasis on Occult Nipple Involvement: The Weill-Cornell Experience with 325 Cases.

Nipple-sparing mastectomy ( NSM) is an increasingly utilized surgical option in managing breast carcinoma; however, data on malignant involvement of a separately submitted nipple margin are scant. Consecutive NSM, including those performed for therapeutic and prophylactic purposes, over a 4-year per...

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Published in:Breast Journal Vol. 20; no. 1; pp. 15 - 22
Main Authors: Eisenberg, Rachel E.K., Chan, Joanna S.Y., Swistel, Alexander J., Hoda, Syed A.
Format: pictorial research tables/charts Journal Article
Published: Wiley-Blackwell Jan/Feb2014
Online Access:View this record in EBSCOhost
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      dt: Jan/Feb2014
      vid: 20
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Pathological Evaluation of Nipple-Sparing Mastectomies with Emphasis on Occult Nipple Involvement: The Weill-Cornell Experience with 325 Cases.
      aug:
        au:
          Eisenberg, Rachel E.K.
          Chan, Joanna S.Y.
          Swistel, Alexander J.
          Hoda, Syed A.
        affil: Department of Pathology & Laboratory Medicine, New York Presbyterian Hospital-Weill Cornell Medical Center, Weill Cornell Medical College
      sug:
        subj:
          Mastectomy Evaluation
          Nipples Pathology
          Human
          Female
          Descriptive Statistics
          Chi Square Test
          Retrospective Design
          Record Review
          Data Analysis, Statistical
          Data Analysis Software
          Male
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Female
          Male
      ab: Nipple-sparing mastectomy ( NSM) is an increasingly utilized surgical option in managing breast carcinoma; however, data on malignant involvement of a separately submitted nipple margin are scant. Consecutive NSM, including those performed for therapeutic and prophylactic purposes, over a 4-year period (2007-2011), were studied. A separately submitted nipple margin was evaluated by permanent H&E preparations and via frozen section evaluation whenever requested. 325 consecutive NSM specimens, 208 (64%) therapeutic- NSM, and 117 (36%) prophylactic- NSM were studied. All nipples were clinically unremarkable. 86% (179/208) of nipple margins from therapeutic- NSM and 100% (117/117) from prophylactic- NSM showed no histopathologic abnormality. 14% (29/208) of nipple margins from therapeutic- NSM and no nipple margin from prophylactic- NSM showed malignancy. Frozen section evaluation was performed in 188/325 NSM (58%) with a sensitivity of 64% and specificity of 99%. Central tumor location and stage N2/N3 lymph node status were significantly associated with nipple margin positivity (χ2 ≤ 0.05). Subsequent nipple resection was performed in 69% (20/29) of nipple margin-positive cases with residual malignancy found in 40% (8/20, including three cases of invasive carcinoma). In a mean follow-up of 33 months, one invasive carcinoma recurred in the 'saved' nipple, 36 months after therapeutic- NSM. 14% (29/208) of nipple margins in therapeutic- NSM and no nipple margin (0/117) in prophylactic- NSM showed malignancy. Central tumor location and N2/N3 stage were significantly associated with nipple margin positivity (χ2 ≤ 0.05).
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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