Camp Melissa S, Coopey Suzanne B, Tang Rong, Colwell Amy, Specht Michelle, Greenup Rachel A, Gadd Michele A, Brachtel Elena, Austen William G, Smith Barbara L
Division of Surgical Oncology, Massachusetts General Hospital, Boston, Massachusetts.
Breast J. 2014 Jul-Aug;20(4):402-7. doi: 10.1111/tbj.12279. Epub 2014 Jun 2.
We evaluated management of positive sub-areolar/nipple duct margins in nipple-sparing mastectomies (NSM) at our institution. Retrospective chart review of all NSM from January 2007 to April 2012 was performed and patient, tumor, and treatment information was collected. Sub-areolar/nipple duct margins included ductal tissue from within the nipple. Of 438 NSM, 22 (5%) had positive sub-areolar/nipple duct margins; 21 of 220 cancer-bearing breasts (10%) and 1 of 218 prophylactic mastectomies (0.5%). Positive margins included four with invasive lobular carcinoma and 18 with ductal carcinoma in situ (DCIS). Management included removal of eight nipples and nine nipple areola complexes (NAC). Four of 17 nipple/NAC specimens had evidence of residual DCIS and none had residual invasive cancer. The majority of nipple/NAC specimens excised for a positive margin had no residual malignancy. Future studies are needed to determine the extent of NAC tissue removal required for positive margins.
我们评估了我院保乳根治术（NSM）中乳晕下/乳头导管切缘阳性的处理情况。对2007年1月至2012年4月期间所有的保乳根治术进行回顾性病历审查，并收集患者、肿瘤及治疗信息。乳晕下/乳头导管切缘包括乳头内的导管组织。在438例保乳根治术中，22例（5%）乳晕下/乳头导管切缘阳性；220例患癌乳房中有21例（10%），218例预防性乳房切除中有1例（0.5%）。切缘阳性包括4例浸润性小叶癌和18例导管原位癌（DCIS）。处理措施包括切除8个乳头和9个乳头乳晕复合体（NAC）。17例乳头/NAC标本中有4例有残余DCIS证据，无一例有残余浸润癌。因切缘阳性而切除的大多数乳头/NAC标本无残余恶性肿瘤。需要进一步研究以确定切缘阳性时所需切除的NAC组织范围。
