Gulben K, Yildirim E, Berberoglu U
Ankara Oncology Training and Research Hospital, Department of Surgery, Ankara, Turkey.
Neoplasma. 2009;56(1):72-5. doi: 10.4149/neo_2009_01_72.
The aim of this study was to evaluate predictive factors for the nipple-areola complex (NAC) involvement, and to define a subgroup of patients who may benefit from skin-sparing mastectomy with the NAC preservation in breast cancer patients. Univariate and multivariate analyses were carried out in the retrospective data of 397 eligible patients. The NAC involvement was histopathologically proved in 58 (14.6%) of the patients. In the multivariate logistic regression analysis showed that tumor location (central vs peripheral; p<0.0001; hazard ratio [HR], 7.5; 95% confidence interval [CI], 3.4-14.6), number of positive axillary lymph nodes (> or = 10 vs <10; p<0.005; HR, 2.9; CI, 1.3-6.1), and lymphatic vascular invasion (yes vs no; p<0.0001; HR, 3.5; CI, 1.7-7.1) were the most important prognostic factors. Whereas patients with 2 or 3 risk factors were accepted as high-risk group for the NAC involvement, those with no or 1 risk factor was defined as low-risk group. These groups had a 50.0% NAC involvement rate and a 8.1% NAC involvement rate, respectively (p<0.0001). In conclusion, this study showed that patients with 2 or 3 predictive factors had a high risk of the NAC involvement. These risk factors should be taken into consideration in patient selection for skin-sparing mastectomy with the NAC preservation. Key words: nipple-areola complex; involvement; breast cancer; mastectomy.
本研究旨在评估乳头乳晕复合体（NAC）受累的预测因素，并确定在乳腺癌患者中可能受益于保留NAC的保乳手术的患者亚组。对397例符合条件患者的回顾性数据进行了单因素和多因素分析。58例（14.6%）患者经组织病理学证实NAC受累。多因素逻辑回归分析显示，肿瘤位置（中央型与周围型；p<0.0001；风险比[HR]，7.5；95%置信区间[CI]，3.4 - 14.6）、腋窝阳性淋巴结数量（≥10个与<10个；p<0.005；HR，2.9；CI，1.3 - 6.1）以及淋巴管侵犯（是与否；p<0.0001；HR，3.5；CI，1.7 - 7.1）是最重要的预后因素。有2个或3个危险因素的患者被视为NAC受累的高危组，无或有1个危险因素的患者被定义为低危组。这些组的NAC受累率分别为50.0%和8.1%（p<0.0001）。总之，本研究表明有2个或3个预测因素的患者NAC受累风险较高。在选择保留NAC的保乳手术患者时应考虑这些危险因素。关键词：乳头乳晕复合体；受累；乳腺癌；乳房切除术。
