{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:59:34Z","timestamp":1769821174991,"version":"3.49.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T00:00:00Z","timestamp":1631577600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Subareolar tissue is examined during nipple-sparing mastectomy (NSM) to minimize the risk of occult malignancy within the preserved nipple. A positive subareolar tissue biopsy typically warrants subsequent nipple excision. We study the factors associated with a positive subareolar tissue biopsy, the rate of residual malignancy in subsequent nipple excisions, and the value of subareolar tissue biopsy intraoperative frozen section (IOF).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We identified 1,026 consecutive NSMs with separately submitted subareolar tissue biopsies over a 5.5-year period. Clinicopathologic data were reviewed. We examined concordance rates between subareolar tissue biopsy and subsequent nipple excisions as well as IOF diagnosis and permanent control diagnosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among cases of therapeutic NSM, the rate of a positive subareolar tissue biopsy was 7.2%. Multifocal\/multicentric disease (P = .0005), presence of lymphovascular invasion (P = .033), and nodal involvement (P = .006) were significantly associated with a positive subareolar tissue biopsy. Thirty-nine of 41 cases with positive subareolar biopsies underwent subsequent nipple excision, with 20 (51%) showing residual carcinoma. Among all IOF samples, 9 (3.3%) showed a discrepancy between the IOF and permanent diagnoses, mostly because of false-negatives.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>A positive subareolar tissue biopsy predicts residual carcinoma in the excised nipples in 51% of cases. IOF is accurate and reliable.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajcp\/aqab126","type":"journal-article","created":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T11:08:40Z","timestamp":1624619320000},"page":"266-272","source":"Crossref","is-referenced-by-count":4,"title":["Subareolar Tissue Biopsy Predicts Occult Nipple Involvement in Nipple-Sparing Mastectomies"],"prefix":"10.1093","volume":"157","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2704-5420","authenticated-orcid":false,"given":"Lucy X","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine , New York, NY , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aya Y","family":"Michaels","sequence":"additional","affiliation":[{"name":"Department of Radiology, Weill Cornell Medicine , New York, NY , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula S","family":"Ginter","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine , New York, NY , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,9,14]]},"reference":[{"key":"2023020711033967700_CIT0001","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1007\/s10549-008-0238-4","article-title":"Does nipple preservation in mastectomy improve satisfaction with cosmetic results, psychological adjustment, body image and sexuality?","volume":"118","author":"Didier","year":"2009","journal-title":"Breast Cancer Res Treat."},{"key":"2023020711033967700_CIT0002","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1002\/bjs.1800740118","article-title":"Nipple preservation during mastectomy","volume":"74","author":"Kissin","year":"1987","journal-title":"Br J Surg."},{"key":"2023020711033967700_CIT0003","doi-asserted-by":"crossref","first-page":"715e","DOI":"10.1097\/PRS.0000000000007326","article-title":"Acute postoperative complications in prepectoral versus subpectoral reconstruction following nipple-sparing mastectomy","volume":"146","author":"Avila","year":"2020","journal-title":"Plast Reconstr Surg."},{"key":"2023020711033967700_CIT0004","doi-asserted-by":"crossref","first-page":"301","DOI":"10.21037\/gs.2018.04.04","article-title":"Evaluation of skin viability in nipple sparing mastectomy (NSM)","volume":"7","author":"Zenn","year":"2018","journal-title":"Gland Surg."},{"key":"2023020711033967700_CIT0005","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1007\/s10434-999-0609-z","article-title":"The incidence of occult nipple-areola complex involvement in breast cancer patients receiving a skin-sparing mastectomy","volume":"6","author":"Laronga","year":"1999","journal-title":"Ann Surg Oncol."},{"key":"2023020711033967700_CIT0006","doi-asserted-by":"crossref","first-page":"1882","DOI":"10.1016\/j.ejca.2015.07.001","article-title":"MRI and intraoperative pathology to predict nipple-areola complex (NAC) involvement in patients undergoing NAC-sparing mastectomy","volume":"51","author":"Ponzone","year":"2015","journal-title":"Eur J Cancer."},{"key":"2023020711033967700_CIT0007","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1097\/01.sap.0000216946.83252.e4","article-title":"Applicability of the nipple-areola complex-sparing mastectomy: a prediction model using mammography to estimate risk of nipple-areola complex involvement in breast cancer patients","volume":"56","author":"Schecter","year":"2006","journal-title":"Ann Plast Surg."},{"key":"2023020711033967700_CIT0008","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.6004\/jnccn.2009.0070","article-title":"NCCN clinical practice guidelines in oncology: breast cancer screening and diagnosis","volume":"7","author":"Bevers","year":"2009","journal-title":"J Natl Compr Canc Netw."},{"key":"2023020711033967700_CIT0009","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.6004\/jnccn.2018.0083","article-title":"Breast cancer screening and diagnosis, version 3.2018, NCCN clinical practice guidelines in oncology","volume":"16","author":"Bevers","year":"2018","journal-title":"J Natl Compr Canc Netw."},{"key":"2023020711033967700_CIT0010","doi-asserted-by":"crossref","first-page":"4948","DOI":"10.1200\/JCO.2008.20.8785","article-title":"Occult nipple involvement in breast cancer: clinicopathologic findings in 316 consecutive mastectomy specimens","volume":"27","author":"Brachtel","year":"2009","journal-title":"J Clin Oncol."},{"key":"2023020711033967700_CIT0011","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/tbj.12517","article-title":"Nipple-sparing mastectomy and sub-areolar biopsy: to freeze or not to freeze? 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