Objective: To evaluate characteristics predictive of nipple-areola complex (NAC) involvement by the breast tumor.
Study design: Cases of infiltrative ductal carcinoma (stages I, IIA and IIB) treated by mastectomy in which the distance between the tumor and the NAC was >or=2 cm were included. NAC involvement was evaluated using serial histological sections. The distance between the tumor and the NAC was measured on mammograms. Other parameters taken into consideration were: tumor size, histological and nuclear grades, vascular invasion, and the presence of an in situ component. For comparisons between categorical variables, the chi-square test or Fisher's exact test were used. Student's t-test was used for numerical variables with normal distribution and the Mann-Whitney U-test was applied when distribution was not normal.
Results: Fifty patients were included. NAC was affected in 12 and unaffected in 38. There was no statistically significant difference in mean age between the unaffected and affected groups (58.9+/-13.5 years versus 55.8+/-12.5 years, p=0.477); however, 13.2% and 58.3% (p=0.046) in the NAC-unaffected and NAC-affected groups, respectively, were <50 years of age. Distance <or=3 cm between the tumor and the NAC on mammograms was found in 60.5% of the NAC-unaffected group and in 100% of the NAC-affected group (p=0.007). With respect to the in situ component, there was a difference between the NAC-unaffected and NAC-affected groups regarding micropapillary pattern (13.2% versus 50.0%; p=0.014) and extensive in situ component (13.2% versus 41.7%; p=0.046). No statistically significant difference was found for any of the other parameters analyzed.
Conclusions: A distance between the tumor and the NAC <or=3 cm, age <50 years, and ductal carcinoma in situ with micropapillary pattern or with an extensive in situ component were factors significantly associated with a higher likelihood of NAC involvement.
2009 Elsevier Ireland Ltd. All rights reserved.