[Clinicopathologic analysis of the nipple-areolar complex occult involvement in early stage breast carcinoma].

OBJECTIVE: The aim of this study was to investigate the incidence of nipple-areola complex (NAG) involvement in stage I - II a breast cancer patients who underwent skin-sparing mastectomy and to determine the associated risk factors, to provide a theoretical basis for modified radical mastectomy preserving NAC and breast reconstruction in early stage breast cancer patients.

METHODS: A total of 68 women with primary breast cancer were included in this study. The following associated risk factors of NAC involvement were assessed and compared with those of non-involvement: the distance from the tumor site to the edge of areola (D), axillary lymph node status, over-expression of HER-2/neu, location of tumor, TNM stage, abnormal nipple (nipple indentation, erosion, discharge), tumor size, age, histological type, as well as status of estrogen receptor (ER) and progesterone receptor (PR), by Chi-square test.

RESULTS: The positive rate of NAG involvement was 13.2%. It decreased with an increase in the distance from the tumor site to the edge of the areola (D) (chi2 = 10.68, P <0.01)), and higher incidence of NAG involvement was found in patients with axillary lymph node metastasis (chi2 = 14. 61, P < 0.01) and over-expression of HER-2/neu (chi2 =6.83, P <0.01). Location of tumor (P <0.01), TNM stage (chi2 =3.85, P <0.05), abnormal nipple (chi2 = 11.65, P<0.01), and tumor size (chi2 =4.13, P <0.05) also had influence on the NAG involvement. No significant correlation between NAC involvement and age (P > 0.05)), histological type (chi2 = 0.07, P > 0.05)), as well as status of estrogen receptor (ER) (chi2 = 0.06, P > 0.05) and progesterone receptor (PR) (chi2 = 0.04, P > 0.05) was found. Most of the NAG involvement was caused by ductal infiltration.

CONCLUSION: In the stage I - II a breast cancer patients, location of tumor, TNM stage, the distance from the tumor site to the edge of areola (D), abnormal nipple, over-expression of HER-2 and metastases in axillary lymph nodes are the primary influential factors of NAG involvement.