TREATMENT OF INTRADUCTAL BREAST-CANCER - NONCOMEDO TYPE

The treatment of intraductal breast carcinoma, ranging from local inci sion alone to modified radical mastectomy, remains controversial. Seve nty-nine patients were treated for intraductal breast carcinoma, nonco medo type at our institution from 1975 to 1991. There were 78 females and one male with a mean age of 58 years and a range from 32 to 90 yea rs. Clinical presentation included a palpable mass in 25 patients, abn ormal mammogram in 60 patients, and nipple discharge in 12 patients. T reatment consisted of local excision in 19 patients, simple mastectomy in 25 patients, and modified radical mastectomy in 35 patients. Twent y-five patients underwent simultaneous prophylactic contralateral mast ectomy. Choice of treatment was determined by physician preference and no differences were seen in family history, parity, nipple discharge, history of fibro-cystic disease, presence of palpable lymph nodes, tu mor size, tumor location, patient age, or mammographic findings. Forty -five patients had multicentric tumors on final pathology. One patient demonstrated an axillary lymph node metastasis following modified rad ical mastectomy raising the question of undetected invasive carcinoma. All patients were free of disease at last evaluation and no differenc es in survival were noted between different treatment groups with a me an follow up of 5 years. We conclude that local excision is an appropr iate option for treatment of intraductal breast carcinoma noncomedo ty pe.