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Invited Critique
January 1, 2004

Breast Conservation Surgery Using Nipple-Areolar Resection for Central Breast Cancers—Invited Critique

Arch Surg. 2004;139(1):38. doi:10.1001/archsurg.139.1.38

In this study, the authors present a series of 15 patients with central tumors treated with breast-conserving surgery and adjuvant radiation therapy. The surgical technique they describe consists of an elliptical incision incorporating the NAC, with dissection extending into the breast parenchyma to obtain negative margins, a procedure sometimes referred to as central quadrantectomy. We concur with the authors that this procedure fulfills the primary goal of breast-conserving surgery for breast cancer; oncologically, the tumor is often easily extirpated to negative margins and, cosmetically, the outcomes have been quite favorable both from patients' and surgeons' perspectives. We have been particularly satisfied with our results in the setting of Paget disease, where excision of the NAC is often obligatory.