Breast-conserving surgery with resection of the nipple-areola complex for subareolar breast carcinoma

Introduction: Breast‐conserving therapy for centrally located tumours has in the past been viewed with reservation, but is now an accepted treatment. There is little published evidence, however, to show that it is safe and cosmetically acceptable. Methods: In a prospective investigation carried out between 1996 and 2002, 44 women had surgery for 45 breast carcinomas with suspected nipple involvement. The breast was conserved and the nipple–areola complex removed. Secondary mastectomy was performed in three women because the tumour was found to reach the resection margin. Forty‐one women underwent further observation. The mean tumour size at the time of operation was 18 (range 4–50) mm. Six women received preoperative chemotherapy. Results: Histologically, there were seven preinvasive and 35 invasive cancers. No local failure had occurred at a median follow‐up of 51 months. Six women developed distant metastasis, of whom five died. The mean score for cosmetic results (evaluated on a scale of 1–5 where a score of 1 was excellent) was 1·5 for patients and 1·7 for physicians. Conclusion: Breast‐conserving therapy is a safe and cosmetically acceptable alternative to mastectomy for subareolar breast cancer. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Mastectomy may not be needed for central tumours