Factors predictive of occult nipple-areolar complex involvement in patients with carcinoma in situ of the breast

Hyeoseong Hwang, Seho Park, JaSeung Koo, Hyung Seok Park, Seung Il Kim, Young Up Cho, Byeongwoo Park, Jung Hyun Yoon, minjung Kim, Eunkyung Kim

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: To investigate predictors of occult nipple-areolar complex (NAC) involvement in patients with carcinoma in situ (CIS) and to validate an online probability calculator (CancerMath; www.lifemath.net/cancer/breastcancer/nipplecalc/index.php). Methods: Mastectomized patients with CIS (n = 104) were retrospectively selected. Clinicopathology and preoperative mammography, ultrasound, and magnetic resonance imaging (MRI) findings were analyzed. Results: Histopathological NAC-positivity was confirmed in 20 (19.2%) patients. Short nipple-tumor distance and suspicious extension to the nipple by mammography were significant but ultrasound was not significant to predict NAC involvement. NAC-positive cases had MRI findings of shorter nipple-tumor distance in both the early and delayed phases. Multivariable regression model showed age >50 years and shorter tumor-nipple distance on the delay phase of MRI were statistically significant predictors of NAC involvement. Area under the receiver operating characteristics curve (AUC) was 0.618 when calculated by CancerMath; however, an AUC of 0.954 was achieved when distance and age were applied together as predictor. Conclusions: Mammographic and MRI findings were significant for predicting NAC involvement, with distance of the tumor from the nipple in delay phase MRI the most significant predictor of NAC involvement. Therefore, breast MRI could be beneficial for planning nipple-sparing mastectomy in patients with CIS.

Original languageEnglish
Pages (from-to)1046-1055
Number of pages10
JournalJournal of surgical oncology
Volume116
Issue number8
DOIs
Publication statusPublished - 2017 Dec 15

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Nipples
Magnetic Resonance Imaging
Carcinoma in Situ
Neoplasms
Breast Carcinoma In Situ
Area Under Curve
Mammary Ultrasonography
Mastectomy
Mammography
ROC Curve
Breast

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Hwang, Hyeoseong ; Park, Seho ; Koo, JaSeung ; Park, Hyung Seok ; Kim, Seung Il ; Cho, Young Up ; Park, Byeongwoo ; Yoon, Jung Hyun ; Kim, minjung ; Kim, Eunkyung. / Factors predictive of occult nipple-areolar complex involvement in patients with carcinoma in situ of the breast. In: Journal of surgical oncology. 2017 ; Vol. 116, No. 8. pp. 1046-1055.
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abstract = "Objectives: To investigate predictors of occult nipple-areolar complex (NAC) involvement in patients with carcinoma in situ (CIS) and to validate an online probability calculator (CancerMath; www.lifemath.net/cancer/breastcancer/nipplecalc/index.php). Methods: Mastectomized patients with CIS (n = 104) were retrospectively selected. Clinicopathology and preoperative mammography, ultrasound, and magnetic resonance imaging (MRI) findings were analyzed. Results: Histopathological NAC-positivity was confirmed in 20 (19.2{\%}) patients. Short nipple-tumor distance and suspicious extension to the nipple by mammography were significant but ultrasound was not significant to predict NAC involvement. NAC-positive cases had MRI findings of shorter nipple-tumor distance in both the early and delayed phases. Multivariable regression model showed age >50 years and shorter tumor-nipple distance on the delay phase of MRI were statistically significant predictors of NAC involvement. Area under the receiver operating characteristics curve (AUC) was 0.618 when calculated by CancerMath; however, an AUC of 0.954 was achieved when distance and age were applied together as predictor. Conclusions: Mammographic and MRI findings were significant for predicting NAC involvement, with distance of the tumor from the nipple in delay phase MRI the most significant predictor of NAC involvement. Therefore, breast MRI could be beneficial for planning nipple-sparing mastectomy in patients with CIS.",
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Factors predictive of occult nipple-areolar complex involvement in patients with carcinoma in situ of the breast. / Hwang, Hyeoseong; Park, Seho; Koo, JaSeung; Park, Hyung Seok; Kim, Seung Il; Cho, Young Up; Park, Byeongwoo; Yoon, Jung Hyun; Kim, minjung; Kim, Eunkyung.

In: Journal of surgical oncology, Vol. 116, No. 8, 15.12.2017, p. 1046-1055.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Factors predictive of occult nipple-areolar complex involvement in patients with carcinoma in situ of the breast

AU - Hwang, Hyeoseong

AU - Park, Seho

AU - Koo, JaSeung

AU - Park, Hyung Seok

AU - Kim, Seung Il

AU - Cho, Young Up

AU - Park, Byeongwoo

AU - Yoon, Jung Hyun

AU - Kim, minjung

AU - Kim, Eunkyung

PY - 2017/12/15

Y1 - 2017/12/15

N2 - Objectives: To investigate predictors of occult nipple-areolar complex (NAC) involvement in patients with carcinoma in situ (CIS) and to validate an online probability calculator (CancerMath; www.lifemath.net/cancer/breastcancer/nipplecalc/index.php). Methods: Mastectomized patients with CIS (n = 104) were retrospectively selected. Clinicopathology and preoperative mammography, ultrasound, and magnetic resonance imaging (MRI) findings were analyzed. Results: Histopathological NAC-positivity was confirmed in 20 (19.2%) patients. Short nipple-tumor distance and suspicious extension to the nipple by mammography were significant but ultrasound was not significant to predict NAC involvement. NAC-positive cases had MRI findings of shorter nipple-tumor distance in both the early and delayed phases. Multivariable regression model showed age >50 years and shorter tumor-nipple distance on the delay phase of MRI were statistically significant predictors of NAC involvement. Area under the receiver operating characteristics curve (AUC) was 0.618 when calculated by CancerMath; however, an AUC of 0.954 was achieved when distance and age were applied together as predictor. Conclusions: Mammographic and MRI findings were significant for predicting NAC involvement, with distance of the tumor from the nipple in delay phase MRI the most significant predictor of NAC involvement. Therefore, breast MRI could be beneficial for planning nipple-sparing mastectomy in patients with CIS.

AB - Objectives: To investigate predictors of occult nipple-areolar complex (NAC) involvement in patients with carcinoma in situ (CIS) and to validate an online probability calculator (CancerMath; www.lifemath.net/cancer/breastcancer/nipplecalc/index.php). Methods: Mastectomized patients with CIS (n = 104) were retrospectively selected. Clinicopathology and preoperative mammography, ultrasound, and magnetic resonance imaging (MRI) findings were analyzed. Results: Histopathological NAC-positivity was confirmed in 20 (19.2%) patients. Short nipple-tumor distance and suspicious extension to the nipple by mammography were significant but ultrasound was not significant to predict NAC involvement. NAC-positive cases had MRI findings of shorter nipple-tumor distance in both the early and delayed phases. Multivariable regression model showed age >50 years and shorter tumor-nipple distance on the delay phase of MRI were statistically significant predictors of NAC involvement. Area under the receiver operating characteristics curve (AUC) was 0.618 when calculated by CancerMath; however, an AUC of 0.954 was achieved when distance and age were applied together as predictor. Conclusions: Mammographic and MRI findings were significant for predicting NAC involvement, with distance of the tumor from the nipple in delay phase MRI the most significant predictor of NAC involvement. Therefore, breast MRI could be beneficial for planning nipple-sparing mastectomy in patients with CIS.

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