Evaluation of Nipple-Areola Complex (NAC) involvement in Breast Carcinoma

Abstract

Objective: This study was undertaken to find the frequency and factors affecting the nipple-areola complex (NAC) in breast carcinoma so as to find the feasibility of nipple-sparing mastectomy (NSM) in the management of breast carcinoma.

Patients and Methods: This study was conducted in Department of Surgery, Tobruk Medical Center, Tobruk, Libya from October 2003 to February 2007. 25 Libyan female patients with carcinoma breast were included in this study. Patients with clinical NAC involvement e.g. ulceration (Paget’s disease), fixation or induration were excluded, whereas those with nipple retraction or discharge were included in the study. All patients were subjected to modified radical mastectomy. Nipple-areola biopsy was done to find its involvement. The NAC was considered involved with malignancy, if the tumor infiltration was within 5 mm of the NAC.

Results: In the present study, out of 25 cases, 3 (12%) showed pathological NAC involvement. NAC involvement was significantly associated with centrally located tumors (P = 0.029), tumors with nipple retraction (P = 0.029) and tumors with skin involvement (P = 0.029). NAC involvement was not associated with age (P = 1.000), laterality of tumor (P = 1.000), tumor size (P = 1.000), tumor grade (P = 0.252), or axillary lymph nodes (P = 0.543).

Conclusion: Nipple-sparing mastectomy may be suitable for selected cases of breast carcinoma with low probability of nipple involvement by carcinoma.