Importance of extensive sampling methodology on the pick up rate of involvement of nipple areola in carcinoma breast .
Keywords:
Breast carcinoma, Grossing technique, Occult lesion, Nipple sparing mastectomy, Comparison of methods
Abstract
Background: Breast cancer is the leading cause of death from cancer for females 40-44 years of age which is responsible for 19% of cancer related death in women.1 The exact percentage of NAC involvement in breast carcinoma cases depends on many parameters. Grossing methodology used can influence the pick up rate of carcinoma involvement in nipple areolar region in cases of carcinoma breast.Methods: Aim of the study was to compare the pick up rate of involvement of nipple areola complex in carcinoma breast cases by extensive nipple areolar sampling vs routine methodology.We studied 30 cases of breast carcinomas using extensive sampling methodology and compared the results with routine sectioning method. All the cases were having grossly uninvolved nipple areolar complex.Chisquare test was used to know if there was an association between the grossing technique and positivity rate of nipple areolar complex. Chi-square table was prepared and statistics was calculated using SPSS software. Result: There was a statistically significant association between the grossing methodology and pick up rate of nipple areolar involvement in carcinoma breast. Conclusion: Our findings showed that, if Only gross involvement of nipple is taken into consideration large amount of occult NAC involvement will be missed out, which can be picked up only by extensive sampling of NAC. Increase in the accuracy of involvement of nipple areolar complex can further guide in the treatment of breast carcinoma cases by nipple sparing mastectomy. DOI: 10.21276/AWCH.1512References
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8. Santini D, Taffurelli M, Gelli MC, Grassigli A, Giosa F et al: Neoplastic involvement of nipple-areolar complex in invasive breast cancer. Am J Surg 1989; 158:399-403
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11. Simmons RM, Brennan M, Christos P, King V, Osborne M. Analysis of nipple/areolar involvement with mastectomy: can the areola be preserved? Ann Surg Oncol 2002; 9: 165-8
12. Brachtel EF, Rusby JE, Michaelson JS, Chen LL, Muzikansky A et al. Occult nipple involvement in breast cancer :clinicopathologic findings in 316 consecutive mastectomy specimens. J Clin Oncol. 2009;27:4948-54
13. Li W, Wang S, Guo X, Lang R et al. Nipple involvement in breast cancer: retrospective analysis of 2323 consecutive mastectomy specimens. Int J Surg Pathol 2011;19:328–334
14. Crowe JP, Kim JA, Yetman R , Banbury J , Patrick RJ et al: Nipple-sparing mastectomy : Technique and results of 54 procedures. Arch Surg 2004 ; 139: 148-150
2. World cancer research fund international page. http://www.wcrf.org/int/cancer-facts-figures/data-specific-cancers/breast-cancer-statistics (accessed march 13, 2017)
3. Smith J, Payne WS, Carney JA. Involvement of Nipple and Areola in Carcinoma of the Breast. Surg Gynecol Obstet 1976;143:546-8.
4. Andersen JA, Gram JB, Pallesen RM (1981) Involvement of the nipple and areola in breast cancer. Value of clinical findings. Scand J Plast Reconstr Surg 15(1):39–42.
5. Menon RS, Geel ANV . Cancer of breast with nipple involvement. Br journal of cancer 1989;59:81-4
6. Verma GR, Kumar A, Joshi K. Nipple involvement in peripheral breast carcinoma :a prospective study. Indian Journal of Cancer 1997;34:1-5.
7. Millard DR, Devine J, and Warren WD. A Plea for Saving the Uninvolved Nipple. Am J Surg 1977;122:763.
8. Santini D, Taffurelli M, Gelli MC, Grassigli A, Giosa F et al: Neoplastic involvement of nipple-areolar complex in invasive breast cancer. Am J Surg 1989; 158:399-403
9. Grossing (histologic sampling) of breast lesions. PathologyOutlines.com website.http://www.pathologyoutlines.com/topic/breastmalignantgrossing.html. (Accessed March 13th, 2017).
10. UCM gross pathology. The university of Chicago. https://grosspathology-sites.uchicago.edu/page/mastectomy (Accessed March 13 th 2017).
11. Simmons RM, Brennan M, Christos P, King V, Osborne M. Analysis of nipple/areolar involvement with mastectomy: can the areola be preserved? Ann Surg Oncol 2002; 9: 165-8
12. Brachtel EF, Rusby JE, Michaelson JS, Chen LL, Muzikansky A et al. Occult nipple involvement in breast cancer :clinicopathologic findings in 316 consecutive mastectomy specimens. J Clin Oncol. 2009;27:4948-54
13. Li W, Wang S, Guo X, Lang R et al. Nipple involvement in breast cancer: retrospective analysis of 2323 consecutive mastectomy specimens. Int J Surg Pathol 2011;19:328–334
14. Crowe JP, Kim JA, Yetman R , Banbury J , Patrick RJ et al: Nipple-sparing mastectomy : Technique and results of 54 procedures. Arch Surg 2004 ; 139: 148-150
Published
2017-05-28
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