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...
| Published in: | Breast Journal Vol. 20; no. 1; pp. 15 - 22 |
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| Main Authors: | , , , |
| Format: | pictorial research tables/charts Journal Article |
| Published: |
Wiley-Blackwell
Jan/Feb2014
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104007398&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104007398 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1075122X ET6 jtl: Breast Journal issn: 1075122X maglogo: Y pubinfo: dt: Jan/Feb2014 vid: 20 iid: 1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 104007398 93792647 10.1111/tbj.12199 NLM24438063 104007398 ppf: 15 ppct: 7 formats: fmt: @attributes: type: P tig: 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 refInfo: holdings: @attributes: islocal: N |
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