Publication: Prediction of nipple involvement in breast cancer after neoadjuvant chemotherapy: Should we rely on breast MRI to preserve the nipple
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Date
2023-01-01
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Abstract
Background: Indications for nipple sparing mastectomy (NSM) is extending to post-neoadjuvant chemotherapy (NAC) setting. Eligibility for NSM with an optimum tumor-nipple distance (TND) after NAC is unclear. We examined predictive factors for nipple tumor involvement in patients undergoing total mastectomy following NAC. Methods: Clinical and pathological data from prospectively collected medical records of women with invasive breast carcinoma, who were undergone NAC and total mastectomy with sentinel lymph node biopsy and/or axillary lymph node dissection were analyzed. PreNAC and postNAC magnetic resonance imaging (MRI) views were examined and a cut-off TND value for predicting the negative nipple tumor status was determined. Results: Among 180 women, the final mastectomy specimen analysis revealed that 12 (7%) had nipple involvement as invasive carcinoma. Patients with nipple involvement had more postNAC multifocal/multicentric tumors (p: 0.03), larger tumors on preNAC and postNAC images (p: 0.002 and p 2mm) on preNAC and postNAC images (p < 0.001 and p: 0.01). The best likelihood ratios (LR) belonged to the postNAC positivity of the < 20 mm TND, with a + LR of 3.40, and − LR of 0.11 for nipple involvement. PreNAC positivity of the < 20 mm TND also had a similar − LR of 0.14. Conclusion: A TND-cut-off ≥ 2 cm on preNAC and postNAC MRI was shown to be highly predictive of negative nipple tumor involvement.
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Tıp, Dahili Tıp Bilimleri, İç Hastalıkları, Onkoloji, Yaşam Bilimleri, Moleküler Biyoloji ve Genetik, Sitogenetik, Sağlık Bilimleri, Temel Bilimler, Medicine, Internal Medicine Sciences, Internal Diseases, Oncology, Life Sciences, Molecular Biology and Genetics, Cytogenetic, Health Sciences, Natural Sciences, Klinik Tıp (MED), Yaşam Bilimleri (LIFE), Klinik Tıp, ONKOLOJİ, BİYOKİMYA VE MOLEKÜLER BİYOLOJİ, Clinical Medicine (MED), Life Sciences (LIFE), CLINICAL MEDICINE, MOLECULAR BIOLOGY & GENETICS, ONCOLOGY, BIOCHEMISTRY & MOLECULAR BIOLOGY, Kanser Araştırmaları, Cancer Research, Breast cancer, Breast magnetic resonance imaging, Neoadjuvant chemotherapy, Nipple involvement
Citation
UĞURLU M. Ü., BUĞDAYCI O., AKMERCAN A., KAYA H., AKIN TELLİ T., AKOĞLU H., GÜLLÜOĞLU M. B., "Prediction of nipple involvement in breast cancer after neoadjuvant chemotherapy: Should we rely on breast MRI to preserve the nipple?", Breast Cancer Research and Treatment, 2023