A domestic research team has presented a new standard to accurately evaluate the possibility of a nipple-areola preserving mastectomy in breast cancer patients.

The research team, led by Professors Jeong Joon and Bae Sung-jun of the Surgical Department and Cha Yoon-jin of the Pathology Department at Gangnam Severance Hospital, presented the results of a study measuring the diagnostic accuracy of non-mass enhancement (NME) on breast MRI before surgery.

About 30 to 40 percent of women with breast cancers undergo a total mastectomy and feel unsatisfied after the surgery from cosmetic viewpoints.

Hospitals have recently begun performing nipple-sparing mastectomy to fulfill the unmet needs of the patients, and the research team explained that the most important thing is to evaluate patients eligible for the surgery accurately.

Magnetic resonance imaging for the breast is the most accurate diagnostic method to evaluate the extent of breast cancer lesions. Non-mass enhancement observed on breast MRI refers to an image in which cancer cells appear to be scattered in an irregular shape without lumps.

The current medical guide recommends not perform a nipple-areolar complex sparing mastectomy if the preoperative cancer lesion invades the nipple or is located within a short distance from the nipple.

The research team conducted a pathological evaluation of 64 patients who underwent breast cancer surgery to remove the nipple-areolar complex due to non-mass enhancement located within two centimeters of the nipple from November 2017 to November 2019.

“In breast MRI, non-massive enhancement has been much more likely to invade the nipple or to be within a short distance from the nipple than for a mass lesion. However, we lacked studies evaluating the diagnostic accuracy of non-mass enhancement based on a precise pathological examination,” Professor Jeong said. “The recent study demonstrated that 86 percent of all cases where non-mass enhancement invaded the nipples on breast MRI had spread to the nipples in the pathological examination.”

Professor Bae also said, “Although additional research is needed, we might be able to try for nipple-areolar complex preservation in these cases carefully.

The study, “Diagnostic accuracy of non-mass enhancement at breast MRI in predicting tumor involvement of the nipple,” was published recently in the latest issue of the international journal Radiology.