CONSERVATIVE TREATMENT FOR BREAST-CANCER WITH A CENTRAL LOCALIZATION - TUMORECTOMY WITH RESECTION OF THE AREOLAR PLAQUE

OBJECTIVES: In breast cancer, retroareolar tumors are observed in 5 to 20% of cases; mammectomy is the conventional treatment. Conservative surgery was used in this series of 36 patients with retroareolar cance r situated less than 2 cm from the areola. PATIENTS AND METHODS: Tumor ectomy with resection of the areolar plaque was followed by radiothera py. Six patients had Paget's disease of the nipple, 64% were in classe s T0 or T1 and 36% in T2. Chemotherapy or radiotherapy was given for t umor reduction prior to surgery in 8 patients. Wide tumorectomy with r esection of the areolar plaque and gland remodeling was performed in a ll patients. Three plastic surgery techniques were used. Mean tumor si ze was 17.3 mm (8 to 33 mm). The areola was invaded in 16 patients (44 %) and the derma or retroareolar ducts in 26 (72%). RESULTS: The mean distance between the tumor and skin surface was 3.8 mm. The section su rface was in healthy tissue in 31 patients and 2 patients underwent su bsequent surgery for mammectomy. Ail patients had either pre-operative (n = 4) or post-operative (n = 32) radiotherapy. Secondary reconstruc tion of the nipple was performed in 14 patients. CONCLUSION: Histology findings and esthetic results suggested that this conservative approa ch can be proposed when the tumor is located close to the areola, as c onfirmed by our series and results from other teams using the same tec hnique.