Involvement of the nipple in early carcinoma of the breast.

Cancerous involvement of the nipple and subareolar tissue (nipple and areolar complex, NAC) was confirmed histopathologically in 24 of 65 patients with gross tumors measuring 2.5 centimeters or less. Erosion of the nipple as a clinical manifestation of involvement of NAC was seen in only two patients. The other 22 were all subclinical. The histologic form of involvement of NAC included intraductal-1 in 19 patients, stromal in one patient, lymphatic in two patients and intraductal-1 as well as stromal in two. Stepcut and serial observation of the whole breast suggested that both intraductal spread and stromal invasion of carcinoma were continuous processes from the underlying tumor. Involvement of NAC was more frequent if the patient was aged 50 years or less and if the proximity of the tumor to the nipple was less than 4 centimeters, regardless of the size of the tumor.