caa a22 4500 445339233 CHVBK 20180317142806.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1245/s10434-011-1908-8 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1908-8 Prophylactic and Therapeutic Mastectomy in BRCA Mutation Carriers: Can the Nipple Be Preserved? [Elektronische Daten] [Carol Reynolds, Jennifer Davidson, Noralane Lindor, Katrina Glazebrook, James Jakub, Amy Degnim, Nicole Sandhu, Molly Walsh, Lynn Hartmann, Judy Boughey] Background: Use of nipple-sparing mastectomy (NSM) is increasing. We sought to look at the role of NSM in BRCA mutation carriers. Methods: Tissue from women with a BRCA1 or BRCA2 mutation who underwent mastectomy between March 1987 and June 2009 at a single institution was reviewed. The entire nipple-areolar complex (NAC) was excised and histologically evaluated. The presence of terminal duct lobular units (TDLUs) and premalignant or malignant lesions in the NAC was noted. Results: Sixty-two NACs from 33 women (25 BRCA1, 8 BRCA2) were studied. TDLUs were present in 15 (24%) NAC specimens. No evidence of atypical hyperplasia, carcinoma in situ, or invasive carcinoma was found in any of the 33 prophylactic mastectomy specimens. Among the 29 breasts with cancer and available tissue, 2 (7%) had malignant findings and 1 (3%) had atypia in the NAC. One woman who underwent bilateral mastectomy for bilateral invasive carcinoma had one nipple with tumor within lymphatics, and her contralateral nipple had atypical lobular hyperplasia. A second woman had ductal carcinoma in situ involving a single major lactiferous duct. Conclusions: The probability of nipple involvement by premalignant or malignant lesions in the NAC of BRCA mutation carriers is low at time of prophylactic mastectomy, but higher (10%) in women undergoing therapeutic mastectomy. NSM may be appropriate and oncologically safe for selected women with BRCA mutations. However, 24% of NACs contained TDLUs, with only 8% found in the nipple papilla; the significance of this for long-term risk is unknown. Society of Surgical Oncology, 2011 Reynolds Carol Department of Pathology, Mayo Clinic, Division of Anatomic Pathology, Rochester, MN, USA aut Davidson Jennifer Department of Pathology, Mayo Clinic, Division of Anatomic Pathology, Rochester, MN, USA aut Lindor Noralane Department of Medical Genetics, Mayo Clinic, Rochester, MN, USA aut Glazebrook Katrina Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN, USA aut Jakub James Department of Surgery, Mayo Clinic, Rochester, MN, USA aut Degnim Amy Department of Surgery, Mayo Clinic, Rochester, MN, USA aut Sandhu Nicole Department of General Internal Medicine, Mayo Clinic, Rochester, MN, USA aut Walsh Molly Division of Plastic Surgery, Mayo Clinic, Rochester, MN, USA aut Hartmann Lynn Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA aut Boughey Judy Department of Surgery, Mayo Clinic, Rochester, MN, USA aut Annals of Surgical Oncology Springer-Verlag 18/11(2011-10-01), 3102-3109 1068-9265 18:11<3102 2011 18 10434 https://doi.org/10.1245/s10434-011-1908-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1908-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Reynolds Carol Department of Pathology, Mayo Clinic, Division of Anatomic Pathology, Rochester, MN, USA aut NATIONALLICENCE 700 1- Davidson Jennifer Department of Pathology, Mayo Clinic, Division of Anatomic Pathology, Rochester, MN, USA aut NATIONALLICENCE 700 1- Lindor Noralane Department of Medical Genetics, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Glazebrook Katrina Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Jakub James Department of Surgery, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Degnim Amy Department of Surgery, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Sandhu Nicole Department of General Internal Medicine, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Walsh Molly Division of Plastic Surgery, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Hartmann Lynn Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 700 1- Boughey Judy Department of Surgery, Mayo Clinic, Rochester, MN, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/11(2011-10-01), 3102-3109 1068-9265 18:11<3102 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer