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E. Shelley Hwang
San Francisco, Calif

Arch Surg. 2004;139:38.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

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.

Several issues pertaining to this study merit consideration. First, this was a small case series with limited follow-up. Furthermore, the median age of the study group was 80 years, . . . [Full Text of this Article]

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