Nipple-sparing mastectomies: Clinical outcomes from a single academic institution

Abstract

Abstract. Nipple-sparing mastectomies (NSMs) are increasingly used in the surgical treatment of patients with breast cancer and for prevention of breast cancer. The present study was performed to review the outcomes of patients undergoing NSMs at a single large university setting. A retrospective chart review was performed on all patients undergoing NSMs from 2008-2014. Charts were reviewed for demographic data and patient characteristics. Tumor and breast size, cancer recurrence and complications were also evaluated. Descriptive statistics were utilized to summarize the findings. From 2008From -2014 NSMs. The mean patient age was 44.4 years (range, 20-77). The average body mass index was 24 (range, 18-47). Breast weight was available for 106 specimens, with a mean weight of 475.5 g (range, 124.1-1,625.0 g). Seventy-three NSMs were performed for cancer and 124 were performed prophylactically. The mean tumor width was 1.38 cm (range, 0-6.0 cm), with an average nipple to tumor distance of 5.87 cm (range, 2.93-10.0 cm). Three (4%) patients required removal of the nipple areolar complex (NAC) due to pathological extension of the tumor. A total of 34 (17.2%) complications occurred, including infections, hematomas and nipple necrosis, with 9 requiring removal of the NAC and 13 requiring removal of the tissue expander or implant. Smokers had a 36.0% (9/25) complication rate, compared with 14.5% (25/172) of nonsmokers (P<0.05). During follow-up, one recurrence was noted, located on the chest wall. There were no recurrences in the NAC group. Therefore, NSMs may safely be performed without compromising oncologic outcomes or increasing complication rates in properly selected patients.

Aesthetic outcome and oncological safety of nipple-sparing mastectomy

“…Furthermore, this study presents infection with loss of mammary implant in one patient and no cases of NAC necrosis. The complication rate presented in our study was of 2.7%, which is lower compared to previous works 1,21,22 . In NSM performed for treatment of breast cancer and risk reduction, the overall complication rate was approximately 5.3% with infection rate of 4.3% 21 .…”

“…Currently, the surgical treatment of the breast aims at improving the aesthetic outcome and the quality of life while still providing oncological safety. Nipple-sparing mastectomy (NSM) has been successfully performed for the treatment of early breast cancer and for women at high risk 1,2 . The surgical technique of NSM preserves the entire skin envelope and the nipple-areola complex (NAC), allowing the immediate breast reconstruction, which confers better aesthetic results 3 .…”

Effectiveness of the Nipples-Saving Mastectomy (NSM): Review on the Results, Oncologic Safety and Surgical Complications

“…The average follow-up varies from 18 to 79 months (Table 1). Most common post-surgery complications were hematoma, occurring in 14.7% of patients of a series, capsular contractures, necrosis [19]. Higher local recurrence ranged from 1-7.3%, [18,27].…”

“…From the research performed, 12 articles have been selected for this work, for a total amount of 2859 patients and 3849 NSM, 772 proven procedures of oncologic prophylaxis related to the studies [17][18][19][20][21][22][23][24][25][26][27][28]. The average follow-up varies from 18 to 79 months (Table 1).…”

“…were. Dull and co-workers, analysed NSM procedures performed from 2008 to 2014, in patients with tumor-nipple distance higher than 2 cm [19]. Manning and co-workers enrolled carriers of BRCA1 mutation, with a tumor-nipple distance higher than 1 cm [22].…”