Article Figures & Tables
Tables
Characteristic Patients with cancer
n = 242Patients undergoing CPM
n = 69Patients undergoing BPM
n = 26Age, yr, mean 52 51.4 49.7 Female, n 242 69 26 Size of lesion on imaging, mm,* mean 21.6 7.54 0 Tumour histology DCIS, n 41 5 1 Size of DCIS, mm, mean (range) 21.7 (0–85) 4.3 (1–9) 1 Invasive cancer, n 201 1 — Size of invasive cancer, mm, mean (range) 16.9 (0–57) 1 — T stage, n Tis 41 5 1 T1 106 — — T2 44 — — T3 3 — — T4 — — — Nottingham grade, n I 42 5 1 II 84 — — III 68 — — Axillary procedure, n SLNB 185 3 — ALND 22 — — None 35 66 26 Nodal status, n Node positive 57/207 — — Node negative 150/207 3/3 — Lymphovascular invasion, n Yes 52/242 1/6 — No 108/242 — 1/1 Invasive tumour subtype, n HR+/HER2− 63/201 2/6 — HR+/HER2+ 10/201 1/6 — HR−/HER2− 13/201 1/6 — HR−/HER2+ 9/201 — — Median follow-up, mo 33.7 44.1 — Neoadjuvant therapy, n Yes 31 — — No 211 69 26 Adjuvant therapy, n Chemotherapy 68 — — Radiation therapy 70 — — Endocrine therapy 137 — — ALND = axillary lymph node dissection; BPM = bilateral prophylactic mastectomy; CPM = contralateral prophylactic mastectomy; DCIS = ductal carcinoma in situ; HER2 = human epidermal growth factor receptor 2; HR = hormone receptor; SD = standard deviation; SLNB = sentinel lymph node biopsy.
↵* Largest size modality of imaging was used among ultrasonography, magnetic resonance imaging and mammogram.
- Table 2
Nipple margin assessment outcomes among patients with cancer or undergoing CPM and BPM who underwent nipple sparing mastectomy
Outcome Patients with cancer n = 242 Patients undergoing CPM
n = 69Patients undergoing BPM
n = 26p value Nipple margin assessment performed 222/242 57/69 17/26 < 0.001 Positive margin 10/222 — — 0.18 Surgery based on nipple margin result 7/10 — — — BPM = bilateral prophylactic mastectomy; CPM = contralateral prophylactic mastectomy.
Patient Tumour histology Tumour size on imaging, cm Tumour size on pathology, cm Clinical distance to nipple, cm Radiological distance to nipple, cm NAT or upfront surgery Incision for NSM Management of positive nipple biopsy Adjuvant therapy 1 DCIS 1.5 3.2 Not palpable 3 Surgery Inframammary fold NAC excision None 2 DCIS 3.8 0* Unknown 0.8 Surgery Inframammary fold Observation None 3 Invasive cancer 4.0 3.5 Not palpable 5.5 Surgery Radial NAC excision Endocrine 4 Invasive cancer 0.1 1.7 NA† NA† Surgery Inframammary fold NAC excision Chemotherapy, RT and endocrine 5 Invasive cancer 1.5 2.2 5 4 Surgery Inframammary fold NAC excision Chemotherapy, RT and endocrine 6 Invasive cancer 7 4.0 5 5 NAT Inframammary fold NAC excision RT and endocrine 7 Invasive cancer 3 1.2 Unknown 6 NAT Inframammary fold NAC excision RT and endocrine 8 Invasive cancer 0.9 1.6 7 7 Surgery Radial NAC excision Endocrine 9 DCIS 9 8.0 2 5 Surgery Circumareolar with lateral extension Observation None 10 DCIS 4.1 4.0 0.5 2 Surgery Inframammary fold Observation Chemotherapy, RT and endocrine DCIS = ductal carcinoma in situ; NA = not applicable; NAC = nipple-areolar complex; NAT = neoadjuvant therapy; NSM = nipple sparing mastectomy; RT = radiation therapy.
↵* Multifocal DCIS.
↵† Patient had a normal mammogram and ultrasonography performed, but had a palpable mass in the axillary tail of left breast, that was excised and revealed invasive lobular cancer with positive margins. The patient had bilateral magnetic resonance imaging (normal), but elected to proceed with NSM.