Local recurrences after mammary adenectomy with clear retroareolar margin for the treatment of early infiltrating breast carcinomas

Abstract Introduction. Mammary adenectomy (MA) is an evolving surgical procedure for patients with breast cancer (BC). It entails the resection of all gross visible glandular tissue, while preserving the overlying breast skin envelope and the nipple-areolar complex (NAC). For achieving the best oncologic outcomes it is recommended the obtainance of clear surgical margins, mainly the retroareolar, and careful selection of the patients to be treated accordingly. Here, we performed a study aiming to assess the local recurrences rate in patients who underwent MA for BC therapy. Methods. A retrospective cross-sectional study was carried out at a private Service (Clínica Prof. Alfredo Barros). Patients with invasive BC measuring up to 3.0 cm and at least 2.0 cm far from the NAC by resonance magnetic imaging, were elegible, while others with more than 3 foci of neoplasia, nipple discharge or neoadjuvant chemotherapy were excluded. All of them were submitted to MA and selective axillary dissection and reconstruction by immediate prothesis implants, with clear retroareolar margin by intraoperative cytology and frozen section exams, and intra-nipple ducts excision. External radiotherapy was delivered when more than 3 affected axillary lymph nodes were involved. Results. A total of 18 cases were analysed. Patient’s mean age was 51.5 years. The histopathologic subtypes were: invasive carcinoma (NOS) 146 (80.7%), infiltrative lobular 26 (14.4%), micropapilar 3 (1.7%) and others 6 (3.3%). Mean tumor size was observed 1.8 cm (0.4-5.0). Multicentricity/multifocality was observed in 62 cases (34.2%) a total of 144 cases presented positivity for estrogen receptor (86.7%), 144 (79.6%) for progesterone receptor, and 29 were HER2 positive (16.0%). In 98 cases (54.1%) a small padge of skin covering the tumor area was removed. Irradiation was ministered to 50 patients (27.6%). After a mean follow up period of 39.9 months (6-178), ten cases of local recurrences were detected (5.5%). No one case of local relapse was detected in the sub-NAC area Conclusion. Our data indicated that the local recurrences rate after therapeutic MA for well selected BC patients is low and acceptable. 2 Citation Format: Rebeca Neves Heinzen, Alfredo CarlosSimõesDornellas de Barros, Alfredo Jacomo, Marcella Cinquini. Local recurrences after mammary adenectomy with clear retroareolar margin for the treatment of early infiltrating breast carcinomas [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-20-10.