Wang Sheng-Ying, Peng De-Feng, Cai Zhao-Gen, Zhang Rong-Zin, Yao Ting-Jing, Zhang Hui, Yang Ming, Dong Hui-Ming
Department of Surgical Oncology, Cancer Hospital of Anhui Province, Bengbu 233004, China.
Zhonghua Zhong Liu Za Zhi. 2008 Mar;30(3):203-6.
The aim of this study was to investigate the incidence of nipple-areola complex (NAG) involvement in stage I - II a breast cancer patients who underwent skin-sparing mastectomy and to determine the associated risk factors, to provide a theoretical basis for modified radical mastectomy preserving NAC and breast reconstruction in early stage breast cancer patients.
A total of 68 women with primary breast cancer were included in this study. The following associated risk factors of NAC involvement were assessed and compared with those of non-involvement: the distance from the tumor site to the edge of areola (D), axillary lymph node status, over-expression of HER-2/neu, location of tumor, TNM stage, abnormal nipple (nipple indentation, erosion, discharge), tumor size, age, histological type, as well as status of estrogen receptor (ER) and progesterone receptor (PR), by Chi-square test.
The positive rate of NAG involvement was 13.2%. It decreased with an increase in the distance from the tumor site to the edge of the areola (D) (chi2 = 10.68, P <0.01)), and higher incidence of NAG involvement was found in patients with axillary lymph node metastasis (chi2 = 14. 61, P < 0.01) and over-expression of HER-2/neu (chi2 =6.83, P <0.01). Location of tumor (P <0.01), TNM stage (chi2 =3.85, P <0.05), abnormal nipple (chi2 = 11.65, P<0.01), and tumor size (chi2 =4.13, P <0.05) also had influence on the NAG involvement. No significant correlation between NAC involvement and age (P > 0.05)), histological type (chi2 = 0.07, P > 0.05)), as well as status of estrogen receptor (ER) (chi2 = 0.06, P > 0.05) and progesterone receptor (PR) (chi2 = 0.04, P > 0.05) was found. Most of the NAG involvement was caused by ductal infiltration.
In the stage I - II a breast cancer patients, location of tumor, TNM stage, the distance from the tumor site to the edge of areola (D), abnormal nipple, over-expression of HER-2 and metastases in axillary lymph nodes are the primary influential factors of NAG involvement.
本研究旨在调查接受保乳皮肤切除乳房切除术的Ⅰ - Ⅱa期乳腺癌患者乳头乳晕复合体（NAG）受累的发生率，并确定相关危险因素，为早期乳腺癌患者保留NAC的改良根治性乳房切除术及乳房重建提供理论依据。
本研究共纳入68例原发性乳腺癌女性患者。评估以下NAC受累的相关危险因素，并与未受累者进行比较：肿瘤部位至乳晕边缘的距离（D）、腋窝淋巴结状态、HER-2/neu过表达、肿瘤位置、TNM分期、乳头异常（乳头凹陷、糜烂、溢液）、肿瘤大小、年龄、组织学类型以及雌激素受体（ER）和孕激素受体（PR）状态，采用卡方检验。
NAG受累的阳性率为13.2%。其随着肿瘤部位至乳晕边缘距离（D）的增加而降低（χ2 = 10.68，P <0.01），腋窝淋巴结转移患者（χ2 = 14. 61，P <0.01）和HER-2/neu过表达患者（χ2 =6.83，P <0.01）中NAG受累的发生率更高。肿瘤位置（P <0.01）、TNM分期（χ2 =3.85，P <0.05）、乳头异常（χ2 = 11.65，P<0.01）和肿瘤大小（χ2 =4.13，P <0.05）也对NAG受累有影响。NAC受累与年龄（P > 0.05）、组织学类型（χ2 = 0.07，P > 0.05）以及雌激素受体（ER）状态（χ2 = 0.06，P > 0.05）和孕激素受体（PR）状态（χ2 = 0.04，P > 0.05）之间无显著相关性。大多数NAG受累是由导管浸润引起的。
在Ⅰ - Ⅱa期乳腺癌患者中，肿瘤位置、TNM分期、肿瘤部位至乳晕边缘的距离（D）、乳头异常、HER-2过表达及腋窝淋巴结转移是NAG受累的主要影响因素。
