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Tumor-to-nipple distance should not impact nipple-sparing mastectomy

A tumor-to-nipple distance as short as 1 cm is not a contraindication for nipple-sparing mastectomy, according to recent research. 

The researchers investigated all nipple-sparing mastectomies between July 2006 and December 2014 to determine whether MRI or sonographic measurements of this distance determine nipple involvement by disease.

There were 195 mastectomies included in the analysis. Sonography was used in 169 cases, MRI was used in 152 cases and 126 cases utilized both imaging techniques.

Using a cutoff distance of 2 cm, findings from patients undergoing sonography showed that nipple-sparing mastectomy candidates carried a 10.7% rate of nipple involvement, compared with 10% for noncandidates (P = .988). With a 1-cm cutoff in the sonography group, the rates were 9.3% for nipple-sparing mastectomy candidates and 15% for noncandidates (P = .307).

On MRI, with a cutoff of 2 cm, candidates carried an 11.6% rate of nipple involvement, compared with 12.5% for noncandidates (P = .881). For a 1-cm cutoff in the MRI group, nipple involvement rates were 11.4% for candidates for nipple-sparing mastectomy and 13.8% for noncandidates (P = .718).

A similar trend held in cases where findings for both imaging techniques were concordant. With a 2-cm cutoff, nipple involvement rates were 8.8% for nipple-sparing mastectomy candidates and 11.8% for non-candidates (P =  .711). With a 1-cm cutoff, the rates were 7.6% for candidates and 14.3% for non-candidates (P = . 535)

“A tumor-to-nipple distance as small as 1 cm, as measured by sonography or [MRI], should not be considered a contraindication to nipple-sparing mastectomy,” the researchers concluded. – by Rob Volansky

Disclosure: The researchers report no relevant financial disclosures.