SIGNIFICANCE OF THE NIPPLE PRESERVED TOTAL GLANDECTOMY IN RELATION TO HISTOLOGICAL TYPES

In this study, we examined the surgical results of 357 patients undergone nipple preserved total glandectomy according to histological subtypes. There were 15 patients with non-invasive carcinoma, 146 with papillotubular carcinoma, 119 with solid-tubular carcinoma, 47 with scirrhous carcinoma, 14 with invasive lobular carcinoma, and 16 with special types except invasive lobular carcinoma. No recurrence was seen in 13 out of the 15 patients with non-invasive ductal carcinoma and in the 16 patients with special types except invasive lobular carcinoma. It has been pointed out that lobular carcinomas pose a problem of multicentric ocurrence. Only one (6%) out of 16 cases of lobular carcinoma including 2 cases of non-invasive one had a recurrence in the flap. Papillotubular carcinomas, which have a tendency to spread intraductally, were locally controlled as well as the other subtypes of invasive ductal carcinoma in the n0 and n1α. Although somewhat poor local control were noted in n1β and n2 cases, no recurrence was seen in the nipple-areolar complex. In conclusion, multicentric occurrence and extensive intraductal component which are risk factors for breast preserved operation can not be so major risk factors for nipple preserved total glandectomy in the local control.