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Risk of Locoregional Recurrence in Patients With False-Negative Frozen Section or Close Margins of Retroareolar Specimen in Nipple-Sparing Mastectomy

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Our purpose was to evaluate the locoregional recurrence (LRR) of patients with false-negative, frozen-section or close margins of retroareolar specimen in nipple-sparing mastectomy (NSM) procedure.

Methods

From 2002–2008, we recruited patients who had atypia or presence of cancer cells in definitive histology of retroareolar tissue despite of absence of tumor cell in intraoperative retroareolar frozen section. We also included the close margin cases defined as the presence of tumor cells at the first frozen section, but after deeper core out of retroareolar tissue were revealed free of malignancy. The incidence of LRR and NAC recurrence were reported, and the factors associated were analyzed.

Results

Of 948 NSM procedures, there were 88 false-negative, frozen-sections and 10 close margin cases. The 5-year cumulative incidence of LRR and NAC recurrence was 11.2 % (10/98 patients) and 2.4 % (2/98 patients), respectively. Analyzing the definitive results of retroareolar tissue, the 5-year cumulative incidence of LRR was 42.9 % (n = 4) for atypia, 10 % (n = 2) for lobular carcinoma in situ (LCIS), 10 % (n = 1) for close margins, 8.7 % (n = 3) for ductal carcinoma in situ (DCIS), and 0 % for invasive carcinoma. In situ carcinoma as a primary tumor was a significant predictor of NAC recurrence (P < 0.01).

Conclusions

Despite a high reliability of frozen section, there is still a minority of false-negative results. Nevertheless, the LRR is considerably low. This fact suggests the possibility of preservation of the NAC after discussion with the patient.

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Conflict of Interest

The authors declare that there is no conflict of commercial interest and no financial or material support.

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Authors and Affiliations

  1. Division of Plastic Reconstruction Surgery, European Institute of Oncology, Milan, Italy

    Maximiliano Cassilha Kneubil MD, Visnu Lohsiriwat MD, Stefano Martella MD, Marco Iera MD, Marcio Brussius Coelho MD, Piercarlo Rey MD, Mario Rietjens MD & Jean Yves Petit MD

  2. Department of Surgery, Faculty of Medicine Mahidol University, Siriraj Hospital, Bangkok, Thailand

    Visnu Lohsiriwat MD

  3. Division of Medical Oncology, Department of Medicine, European Institute of Oncology, Milan, Italy

    Giuseppe Curigliano MD, PhD & Janaina Brollo MD

  4. Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy

    Edoardo Botteri MSc & Nicole Rotmensz MSc

  5. Division of Pathology, European Institute of Oncology, Milan, Italy

    Mauro Giuseppe Mastropasqua MD

  6. Division of Breast Surgery, European Institute of Oncology, Milan, Italy

    Mattia Intra MD

  7. Division of Radiotherapy, European Institute of Oncology, Milan, Italy

    Roberto Orecchia MD

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  1. Maximiliano Cassilha Kneubil MD
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  2. Visnu Lohsiriwat MD
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  3. Giuseppe Curigliano MD, PhD
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Correspondence to Visnu Lohsiriwat MD.

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Kneubil, M.C., Lohsiriwat, V., Curigliano, G. et al. Risk of Locoregional Recurrence in Patients With False-Negative Frozen Section or Close Margins of Retroareolar Specimen in Nipple-Sparing Mastectomy. Ann Surg Oncol 19, 4117–4123 (2012). https://doi.org/10.1245/s10434-012-2514-0

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  • DOI: https://doi.org/10.1245/s10434-012-2514-0

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