caa a22 4500 44533908X CHVBK 20180317142806.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1245/s10434-011-2008-5 doi (NATIONALLICENCE)springer-10.1245/s10434-011-2008-5 Preoperative Predictors of Nipple-Areola Complex Involvement for Patients Undergoing Mastectomy for Breast Cancer [Elektronische Daten] [Julie Billar, Amylou Dueck, Richard Gray, Nabil Wasif, Barbara Pockaj] Background: Proper patient selection is important for nipple-sparing mastectomy, and we aimed to identify preoperative factors predictive of pathologic nipple-areola complex (NAC) involvement to assist with surgical planning. Methods: We retrospectively reviewed a prospectively collected database of patients who underwent mastectomy for DCIS or invasive breast cancer at a single institution. Cases with NAC involvement, NAC(+), were compared with those without NAC involvement, NAC(−). Multivariate logistic regression analysis was performed to determine preoperative factors independently predictive of NAC involvement. Results: A total of 238 standard, 107 skin-sparing, and 47 nipple-sparing mastectomies were performed, and the NAC was pathologically involved in 16% (N=62). Clinical NAC involvement, as determined by patient symptoms or physical exam, was present in 61% of NAC(+) but only 14% of NAC(−) cases (P<.0001) and carried a 92% negative predictive value (NPV). Preoperative imaging involved the NAC in 38% of NAC(+) but only 4% of NAC(−) cases (P<.0001) and carried an 89% NPV. NAC(+) tumors were larger, with mean size 3.3cm versus 2.5cm for NAC(−) tumors (P=.024). The mean tumor-to-nipple distance was 2.0cm for NAC(+) versus 4.7cm for NAC(−) tumors (P<.0001). On multivariate analysis, independent predictors of NAC involvement were the presence of clinical NAC involvement (odds ratio [OR] 5.11, 95% confidence interval [95% CI] 2.53-10.35) and imaging involvement of the NAC (OR 5.82, 95% CI 2.43-13.94). Conclusions: Clinical and imaging abnormalities at the NAC are the only independent preoperative predictors of NAC pathology, and the absence of these factors conveys a low probability of NAC involvement. Society of Surgical Oncology, 2011 Billar Julie Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut Dueck Amylou Department of Biostatistics, Mayo Clinic in Arizona, Phoenix, AZ, USA aut Gray Richard Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut Wasif Nabil Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut Pockaj Barbara Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut Annals of Surgical Oncology Springer-Verlag 18/11(2011-10-01), 3123-3128 1068-9265 18:11<3123 2011 18 10434 https://doi.org/10.1245/s10434-011-2008-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-2008-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Billar Julie Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut NATIONALLICENCE 700 1- Dueck Amylou Department of Biostatistics, Mayo Clinic in Arizona, Phoenix, AZ, USA aut NATIONALLICENCE 700 1- Gray Richard Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut NATIONALLICENCE 700 1- Wasif Nabil Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut NATIONALLICENCE 700 1- Pockaj Barbara Department of General Surgery, Mayo Clinic in Arizona, Phoenix, AZ, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/11(2011-10-01), 3123-3128 1068-9265 18:11<3123 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer