G Mariscotti1, M Durando2, N Houssami3, C M Berzovini2, F Esposito2, M Fasciano2, P P Campanino4, D Bosco2, R Bussone5, A Ala5, I Castellano6, A Sapino7, L Bergamasco8, P Fonio2, G Gandini2. 1. Department of Diagnostic Imaging and Radiotherapy, Radiology Institute, University of Turin, Turin, Italy. Electronic address: giovanna.mariscotti@libero.it. 2. Department of Diagnostic Imaging and Radiotherapy, Radiology Institute, University of Turin, Turin, Italy. 3. Screening and Test Evaluation Program, School of Public Health, Sydney Medical School, University of Sydney, Sydney, 2006, NSW, Australia. 4. Breast Imaging Service, Koelliker Hospital, Turin, Italy. 5. Breast Surgery, Department of Surgery, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette, Turin, Italy. 6. Department of Biomedical Sciences and Human Oncology, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette, Turin, Italy. 7. Fondazione del Piemonte per l'Oncologia (FPO), Candiolo Cancer Institute (IRCCs), Turin, Italy. 8. Department of Surgical Sciences, University of Turin, A. O. U. Città della Salute e della Scienza di Torino, Presidio Ospedaliero Molinette, C.so Bramante 88, 10126, Torino, Italy.
Abstract
AIM: To identify clinically occult nipple-areola complex (NAC) involvement using preoperative magnetic resonance imaging (MRI), to inform selection of patients eligible for nipple-sparing mastectomy (NSM) or skin-sparing mastectomy (SSM). MATERIAL AND METHODS: This was a retrospective study of 195 patients, who had preoperative breast MRI (February 2011 to January 2017) before undergoing surgical treatments (NSM or SSM) for newly diagnosed breast cancer. Tumour features at MRI (mass or non-mass lesion, diameter, lesion-NAC distance [LND]) and pathology (lesion diameter, histopathological type, receptor status) were recorded, as well as the type of surgery (NSM/SSM) and presence (NAC+) or absence (NAC-) of tumour at intraoperative evaluation of retroareolar tissue. Mann-Whitney test, Fisher's exact test, logistic regression, and receiver operating characteristic (ROC) curve analysis were used for analysis of NAC+ versus NAC- to assess variables that predict NAC tumoural involvement. RESULTS: Over the study period, NAC+ was proven histologically in 71/200 (35.5%) surgical treatments, while there were 129/200 NAC- (72 NSM and 128 SSM performed). LND at MRI was statistically (p<0.001) lower in NAC+ patients than in NAC- patients. The area under the ROC curve (0.82, 95% confidence interval [CI]: 0.76-0.88) indicated 10 mm as the best cut-off, with sensitivity of 82%, specificity of 72%, and accuracy of 79%. A 5-mm cut-off enhanced sensitivity, whereas a 15-mm cut-off favoured specificity. CONCLUSIONS: MRI is a useful tool for identifying NAC+ patients; a 10-mm cut-off for LND assists selection of patients for NSM, although intraoperative retroareolar tissue examination remains mandatory.
AIM: To identify clinically occult nipple-areola complex (NAC) involvement using preoperative magnetic resonance imaging (MRI), to inform selection of patients eligible for nipple-sparing mastectomy (NSM) or skin-sparing mastectomy (SSM). MATERIAL AND METHODS: This was a retrospective study of 195 patients, who had preoperative breast MRI (February 2011 to January 2017) before undergoing surgical treatments (NSM or SSM) for newly diagnosed breast cancer. Tumour features at MRI (mass or non-mass lesion, diameter, lesion-NAC distance [LND]) and pathology (lesion diameter, histopathological type, receptor status) were recorded, as well as the type of surgery (NSM/SSM) and presence (NAC+) or absence (NAC-) of tumour at intraoperative evaluation of retroareolar tissue. Mann-Whitney test, Fisher's exact test, logistic regression, and receiver operating characteristic (ROC) curve analysis were used for analysis of NAC+ versus NAC- to assess variables that predict NACtumoural involvement. RESULTS: Over the study period, NAC+ was proven histologically in 71/200 (35.5%) surgical treatments, while there were 129/200 NAC- (72 NSM and 128 SSM performed). LND at MRI was statistically (p<0.001) lower in NAC+ patients than in NAC- patients. The area under the ROC curve (0.82, 95% confidence interval [CI]: 0.76-0.88) indicated 10 mm as the best cut-off, with sensitivity of 82%, specificity of 72%, and accuracy of 79%. A 5-mm cut-off enhanced sensitivity, whereas a 15-mm cut-off favoured specificity. CONCLUSIONS: MRI is a useful tool for identifying NAC+ patients; a 10-mm cut-off for LND assists selection of patients for NSM, although intraoperative retroareolar tissue examination remains mandatory.
Authors: Rebeca Neves Heinzen; Alfredo Carlos Simões Dornellas de Barros; Filomena Marino Carvalho; Fernando Nalesso Aguiar; Cristiane da Costa Bandeira Abrahão Nimir; Alfredo Luiz Jacomo Journal: Gland Surg Date: 2020-06
Authors: Tracy-Ann Moo; Carolina Rossi Saccarelli; Elizabeth J Sutton; Varadan Sevilimedu; Kate R Pawloski; Timothy M D'Alfonso; Mary C Hughes; Jill S Gluskin; Almir Bitencourt; Elizabeth A Morris; Audree Tadros; Monica Morrow; Mary L Gemignani; Virgilio Sacchini Journal: Ann Surg Oncol Date: 2021-04-17 Impact factor: 4.339
Authors: Emad Alsharif; Jai Min Ryu; Hee Jun Choi; Seok Jin Nam; Seok Won Kim; Jonghan Yu; Byung Joo Chae; Se Kyung Lee; Jeong Eon Lee Journal: J Breast Cancer Date: 2019-10-07 Impact factor: 3.588