大社区医院系统中保乳乳头切缘阳性与肿瘤学结局。
Positive Nipple Margins and Oncologic Outcomes of Nipple-Sparing Mastectomy in a Large Community-Based Hospital System.
机构信息
Department of Surgical Oncology, Novant Health Cancer Institute, Charlotte, NC, USA.
Department of Medical Oncology, Novant Health Cancer Institute, Charlotte, NC, USA.
出版信息
Am Surg. 2023 Jul;89(7):3248-3250. doi: 10.1177/00031348231157906. Epub 2023 Feb 16.
The American Society of Breast Surgeons recommends sending separate nipple margins (NMs) when performing nipple-sparing mastectomies (NSMs). However, the definition of a positive NM is vague. We evaluated NM management and outcomes in breast cancer patients undergoing NSM from 2010 to 2021 at our community-based hospital system through a retrospective review and descriptive analysis. A total of 619 patients (1086 NSM) were included. Median invasive tumor size was 1.5cm and median follow-up 30 months. Fourteen therapeutic NSMs had tumor within the NMs. Nine were positive using the definition "any tumor within the separate NM," and nipple-areolar complex (NAC) excised. Two were negative when positive was defined as "any tumor on ink," and were observed without recurrence. Our results suggest positive NMs warranting NAC excision could be interpreted as "any tumor on ink" and NSMs can be safely performed with low rates of positive NMs and recurrences in high-volume hospitals.
美国乳腺外科医师学会建议在进行保乳乳头切除术（NSM）时分别送检乳头边缘（NMs）。然而，阳性 NM 的定义较为模糊。我们通过回顾性研究和描述性分析，评估了 2010 年至 2021 年在我们社区医院系统中接受 NSM 的乳腺癌患者的 NM 管理和结局。共纳入 619 例患者（1086 例 NSM）。浸润性肿瘤的中位大小为 1.5cm，中位随访时间为 30 个月。14 例保乳乳头切除术有肿瘤位于 NM 内。其中 9 例按照“NM 内有任何肿瘤”的定义为阳性，并切除乳头乳晕复合体（NAC）。当定义为“墨水上有任何肿瘤”时，有 2 例为阴性，且未复发。我们的结果表明，需要切除 NAC 的阳性 NM 可解释为“墨水上有任何肿瘤”，在高容量医院中，NSM 可安全进行，阳性 NM 和复发率较低。
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