Is nipple sparing mastectomy associated with increased complications, readmission and length of stay compared to skin sparing mastectomy?

Wang, Melinda; Huang, Julian; Chagpar, Anees B.

doi:10.1016/j.amjsurg.2019.09.011

Cited by 13 publications

(6 citation statements)

References 34 publications

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“…According to Rezai out of 118 patients who underwent BCS, only four patients (or 3.3%) suffered wound infections, while 27 patients (or 22.8%) had seroma. 31,32 Patients in our study have occasionally run into complications. Four patients who underwent BCS developed seroma, 2 had hematomas and one had wound infection, there was no incidence of flap necrosis in this group.…”

Section: Discussionmentioning

confidence: 75%

“…In a study of 82 patients, Wang et al found that the MRM group's average operating duration was 2.5 hours (80-190 minutes). 30,31 Operation times tend to be shorter in specialist high-volume centers and depend on the operating surgeon's skills. In our study, we found that the average hospital stay was 9.0 days for breast conservative surgery and 13.0 days for MRM group.…”

Section: Discussionmentioning

confidence: 99%

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Comparative study between breast conservative surgery and modified radical mastectomy in early stage of breast carcinoma in a tertiary care hospital

Joty

Saiyara²,

Shishir³

et al. 2023

Int J Res Med Sci

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Background: Breast cancer is the most prevalent cancer in women globally, with two million new cases and more than half a million deaths each year. Surgery is the key component of treating breast cancer and there are two primary types of breast surgery available: breast conservative surgery and modified radical mastectomy. The aim of this study was to compare BCS and MRM in the treatment of early-stage breast carcinoma. Methods: This was a prospective observational study that involved 74 patients and was carried out in the Department of Surgery at Shaheed Suhrawardy Medical College & Hospital and Enam Medical College & Hospital with an 18-months minimum follow-up. The time frame for inclusion was from July 2018 through July 2020. There were two patient groups, 37 patients in Group A who underwent breast conservative surgery and Group B was made up of 37 individuals who had MRM for early-stage breast carcinoma. Results: With a mean age of 47.65 years in the BCS group and 48.19 years in the MRM group, the operative time for BCS was 1.04±0.25 hours, whereas 3.20±0.48 hours for MRM. Statistically significant higher amount of post-operative drainage volume in MRM group compared to BCS group (p value=0.000). With an excellent aesthetic outcome rate in BCS group (p value<0.0001) as well as better quality of life than MRM group. Conclusions: Breast conservative surgery and modified radical mastectomy are both oncologically safe treatments for early-stage breast cancer with multidisciplinary approach. BCS offers less trauma, infection and hospital stay; better aesthetic outcome and quality of life than MRM, making it more deserving of being promoted clinically in the treatment of early-stage breast cancer.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Comparative study between breast conservative surgery and modified radical mastectomy in early stage of breast carcinoma in a tertiary care hospital

Joty

Saiyara²,

Shishir³

et al. 2023

Int J Res Med Sci

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“…Headon et al in a pooled analysis of 12 358 NSM procedures reported only a 5.9% rate of nipple necrosis 59 . A single institution study by Wang et al 51 showed that while 16.5% of patients had some nipple ischemia, eschar, or necrosis, only 5.6% ultimately required reoperation to remove the nipple. Valero et al 18 similarly reported a low rate of nipple excision of 4.5%.…”

Section: Trouble Shootingmentioning

confidence: 99%

“…Many studies show no increase in complication rates with NSM compared to SSM, specifically infection, seroma, capsular contracture, and hemorrhage 51,52 . More recent publications have focused on complication rates with NSM in the setting of prior radiation and similarly show good outcomes 18,53 .…”

Section: Trouble Shootingmentioning

confidence: 99%

The modern approach to the nipple‐sparing mastectomy

Kopkash

Sisco

Poli

et al. 2020

Journal of Surgical Oncology

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A modern perspective on the nipple-sparing mastectomy (NSM) looking at current indications as well as the most up-to-date evidence both in the literature and from our institution. There is an in-depth description of our NSM technique and an overview of alternative approaches, including the robotic technique. The complicated concept of the learning curve is addressed and ideas on how to train other NSM adopters. K E Y W O R D S breast cancer risk reduction, breast cancer surgery, nipple-sparing mastectomy, robotic nipple-sparing mastectomy, surgical technique

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“…(50)(51)(52)(53)(54)(55) For cytology, pooled sensitivity was only 38%, although the pooled specificity was high (90%) (Supplemental Figure 4), indicating that cytology is not very useful for the detection of breast cancer in patients with PND. 13 However, biomarker analysis of nipple discharge, as by RNA assessment, 69 may be more promising 6,[70][71][72][73][74][75][76][77] .…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive approach to diseases of the breast and contemporary factors affecting breast cancer surgery

Filipe¹

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Dit proefschrift werd (mede) mogelijk gemaakt met financiële steun van TTW-KWF, Van Herk Ventures, Leander Healthcare B.V en SeederDeBoer . ContentsChapter 1. General outlinePart I: Intraductal diagnosis of breast lesions.Chapter 2.Network meta-analysis for the diagnostic approach to pathologic nipple discharge Chapter 3.Interventional ductoscopy as an alternative for major duct excision or microdochectomy in gomen suffering pathologic nipple discharge: a single-center experience. Chapter 4.Detection of breast cancer precursor lesions by autofluorescence ductoscopy.Chapter 5. Feasibility of narrow band imaging ductoscopy, intraductal biopsy and intraductal laser ablation in patients with pathological nipple discharge and patients with a high-risk for the development of breast cancer: a study protocol.Part II: Minimally invasive treatment of diseases of the breast. Chapter 6.Cost-effectiveness analysis, systematic review and meta-analysis of ductoscopy, duct excision surgery and MRI for the diagnosis and treatment of patients with pathological nipple discharge. 10Chapter 1 General Outline Pathological nipple dischargePathologic nipple discharge (PND) is defined as spontaneous unilateral bloody or serous discharge from a single orifice of the nipple. It is a common breast-related complaint for referral due to its association with breast cancer. [1][2][3][4] However, when ultrasound and mammography are negative, 95% of the PND have a benign cause (duct ectasias and intraductal papillomas). 5,6 Diagnostic work-up of PNDMammography and breast ultrasound are the commonly used diagnostic tools for the detection of breast cancer. However, when PND is the only symptom, they often miss breast cancer. 7 Conversely, magnetic resonance imaging (MRI) has a high true positive rate for the detection of breast cancer but at the same time shows a high number of false positive results in patients with PND. 8,9 Treatment strategies for PND Microdochectomy and major duct excision are currently the most common used methods to rule out malignancy and treat patients with PND without radiological signs of malignancy. 5,7,8 These surgical procedures are performed under general anesthesia and are associated with scarring, which may result in breastfeeding difficulties in fertile women and loss of sensitivity in the nipple. 10General outline

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Is nipple sparing mastectomy associated with increased complications, readmission and length of stay compared to skin sparing mastectomy?

Cited by 13 publications

References 34 publications

Comparative study between breast conservative surgery and modified radical mastectomy in early stage of breast carcinoma in a tertiary care hospital

Comparative study between breast conservative surgery and modified radical mastectomy in early stage of breast carcinoma in a tertiary care hospital

The modern approach to the nipple‐sparing mastectomy

Minimally invasive approach to diseases of the breast and contemporary factors affecting breast cancer surgery

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