J Korean Surg Soc.  2010 Oct;79(4):275-280. 10.4174/jkss.2010.79.4.275.

Central Lumpectomy with Resection of the Nipple-areolar Complex for Retroareolar or Central Breast Cancers

• Lim RJ
• Lee KS
• Lee SH
• Yoon CS
• Ko SS
• Hur MH
• Lee HK
• Hong SR
• Lee JH
• Kang SS

• KMID: 2145029
• DOI: http://doi.org/10.4174/jkss.2010.79.4.275

Abstract

PURPOSE
This study was conducted to evaluate the outcome of central lumpectomy for breast conservation including nipple-areolar resection and postoperative radiation therapy in patients with central breast cancers.
METHODS
19 patients with central breast cancers, aged 39 to 72 years, operated on from May 2004 to March 2010 were identified. Recurrence, survival, and cosmesis were analyzed. Treatment was undertaken as complete excision of the nipple-areolar complex (NAC), followed by external radiation to the whole breast and tumor bed. The mean follow-up period was 37.9 (1 to 71) months.
RESULTS
At pathology, 13 had invasive ductal carcinoma; 5 had ductal carcinoma in situ. 1 had neuroendocrine cancer. Only 1 had atypical ductal hyperplasia at resection margin; the remaining 18 were free margins. The mean tumor size was 1.6 cm (range, 0.8~4 cm) and the distance from the nipple was 0~1 cm. 37.5% had positive axillary nodes. Adjuvant chemotherapy was given for 12 patients, followed by radiation therapy. All 15 patients, who were hormone receptor positive, were given tamoxifen or aromatase inhibitors. With a mean follow up of 37.9 months, all 19 patients are alive and free of disease. Cosmetic results ranged from good to excellent in 18 (94.7%) patients, as judged by both the patients and the surgeons.
CONCLUSION
Although this study needs further evaluation and long-term follow up, subareolar or central breast cancers can be successfully treated with breast conserving therapy using nipple-areolar resection and postoperative radiation therapy, along with acceptable cosmesis.

Keyword

Central breast cancer; Central lumpectomy; Nipple-areolar complex (NAC)

MeSH Terms

Aged
Aromatase Inhibitors
Breast
Carcinoma, Intraductal, Noninfiltrating
Chemotherapy, Adjuvant
Cosmetics
Follow-Up Studies
Humans
Hyperplasia
Mastectomy, Segmental
Nipples
Recurrence
Tamoxifen
Aromatase Inhibitors
Cosmetics
Tamoxifen

Figure

• 

  Fig. 1 A 46-year-old patient with ductal carcinoma in situ who had a 1 cm tumor on Rt. breast. Although her breast has slight volume discrepancy, the result was assessed good.

• 

  Fig. 2 A 63-year-old patient with invasive ductal carcinoma who had a 1.4 cm tumor and negative axillary lympn node. Her breasts are nearly symmetrical and the result was assessed as excellent.

• 

  Fig. 3 A 72-year-old patient with invasive ductal carcinoma who had a 1.5 cm tumor on Lt. breast although the breast is smaller, its contour and natural shape have been preserved. The result was assessed as good.

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