TY - JOUR
T1 - Improved sub-areolar breast tissue removal in nipple-sparing mastectomy using hydrodissection
AU - Folli, Secondo
AU - Curcio, Annalisa
AU - Buggi, Federico
AU - Mingozzi, Matteo
AU - Lelli, Dario
AU - Barbieri, Cristina
AU - Asioli, Silvia
AU - Nava, Maurizio Bruno
AU - Falcini, Fabio
PY - 2012/4
Y1 - 2012/4
N2 - We report on a new technique of dissection of the nipple-areola-complex (NAC) in nipple-sparing mastectomy (NSM). NACs removed due to the presence of tumor cells beneath them were histologically examined for the presence of normal breast glandular tissue. Cases were divided into cohort 1, where NACs were dissected by sharp isolation, coring the nipple, and cohort 2, where the same procedure was preceded by hydrodissection of the areola. In 20 (17.4%) cases the planned NSM was converted to skin-sparing mastectomy (SSM) because of intraoperative findings of cancer in retro-areolar tissue. Histological examination of 20 NSMs converted to SSM showed the presence of glandular tissue in 12 out of 13 cohort 1 cases (92%) and in 1 out of 7 cohort 2 cases (14%). We conclude that hydrodissection creates a subdermal plane facilitating NAC dissection and permitting a more complete removal of breast tissue in NSM. Such radicality could prove important in the treatment of breast cancer and in BRCA 1-2 mutation carriers because of its potential for reducing the risk of relapse.
AB - We report on a new technique of dissection of the nipple-areola-complex (NAC) in nipple-sparing mastectomy (NSM). NACs removed due to the presence of tumor cells beneath them were histologically examined for the presence of normal breast glandular tissue. Cases were divided into cohort 1, where NACs were dissected by sharp isolation, coring the nipple, and cohort 2, where the same procedure was preceded by hydrodissection of the areola. In 20 (17.4%) cases the planned NSM was converted to skin-sparing mastectomy (SSM) because of intraoperative findings of cancer in retro-areolar tissue. Histological examination of 20 NSMs converted to SSM showed the presence of glandular tissue in 12 out of 13 cohort 1 cases (92%) and in 1 out of 7 cohort 2 cases (14%). We conclude that hydrodissection creates a subdermal plane facilitating NAC dissection and permitting a more complete removal of breast tissue in NSM. Such radicality could prove important in the treatment of breast cancer and in BRCA 1-2 mutation carriers because of its potential for reducing the risk of relapse.
KW - Invasive breast cancer
KW - NAC dissection
KW - Nipple-sparing mastectomy
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UR - http://www.scopus.com/inward/citedby.url?scp=84858748304&partnerID=8YFLogxK
U2 - 10.1016/j.breast.2011.09.010
DO - 10.1016/j.breast.2011.09.010
M3 - Article
C2 - 21967772
AN - SCOPUS:84858748304
VL - 21
SP - 190
EP - 193
JO - Breast
JF - Breast
SN - 0960-9776
IS - 2
ER -