Nipple-sparing mastectomy with different approaches: surgical incisions, complications, and cosmetic results. Preliminary results of 100 consecutive patients at a single center

Corso, Giovanni; Lorenzi, Francesca De; Vicini, Elisa; Pagani, Gianmatteo; Veronesi, Giulia; Sargenti, Manuela; Magnoni, Francesca; Naninato, Paola; Maisonneuve, Patrick; Sangalli, Claudia; Rietjens, Mario; Galimberti, Viviana

doi:10.1016/j.bjps.2018.07.022

Cited by 22 publications

(21 citation statements)

References 25 publications

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“…NSM is technically challenging, as the surgeon must completely and precisely remove the mammary gland by preserving the skin envelope with its sub-dermal vascularization, the nipple, and the inframammary folds [85]. The upper outer linear skin incision is the most commonly used, but surgical approach can be personalized in relation to several clinical peculiarities-indeed, different skin incisions for NSM have been proposed in the literature (hemi-periareolar, round block, vertical pattern, and wise pattern skin incisions) [86].…”

Section: Surgical Managementmentioning

confidence: 99%

Hereditary Gastric and Breast Cancer Syndromes Related to CDH1 Germline Mutation: A Multidisciplinary Clinical Review

Corso

Montagna

Figueiredo

et al. 2020

Cancers

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E-cadherin (CDH1 gene) germline mutations are associated with the development of diffuse gastric cancer in the context of the so-called hereditary diffuse gastric syndrome, and with an inherited predisposition of lobular breast carcinoma. In 2019, the international gastric cancer linkage consortium revised the clinical criteria and established guidelines for the genetic screening of CDH1 germline syndromes. Nevertheless, the introduction of multigene panel testing in clinical practice has led to an increased identification of E-cadherin mutations in individuals without a positive family history of gastric or breast cancers. This observation motivated us to review and present a novel multidisciplinary clinical approach (nutritional, surgical, and image screening) for single subjects who present germline CDH1 mutations but do not fulfil the classic clinical criteria, namely those identified as—(1) incidental finding and (2) individuals with lobular breast cancer without family history of gastric cancer (GC).

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Section: Surgical Managementmentioning

confidence: 99%

Hereditary Gastric and Breast Cancer Syndromes Related to CDH1 Germline Mutation: A Multidisciplinary Clinical Review

Corso

Montagna

Figueiredo

et al. 2020

Cancers

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“…The authors retrospectively investigated 117 surgical procedures performed in 100 patients with BC, specifically looking at the following types of incision: hemi-peri-areolar, round block approach or complete peri-areolar, vertical pattern and wise pattern. No significant correlations between clinical and pathological data, complications, pre-and post-surgery satisfactions and specific characteristics, such as ptosis and breast size, were identified, confirming that these techniques are oncologically safe [91].…”

Section: Conservative Mastectomymentioning

confidence: 88%

“…The increasingly conservative character of mastectomy is well represented in a recent report by Corso and co-workers, who documented the oncological and cosmetic effects of different types of surgical incisions during NMS, depending on the size of breast and areola and on the degree of breast ptosis [91] (Figure 2). The authors retrospectively investigated 117 surgical procedures performed in 100 patients with BC, specifically looking at the following types of incision: hemi-peri-areolar, round block approach or complete peri-areolar, vertical pattern and wise pattern.…”

Section: Conservative Mastectomymentioning

confidence: 99%

Breast Cancer Surgery: New Issues

et al. 2021

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Since ancient times, breast cancer treatment has crucially relied on surgeons and clinicians making great efforts to find increasingly conservative approaches to cure the tumor. In the Halstedian era (mid-late 19th century), the predominant practice consisted of the radical and disfiguring removal of the breast, much to the detriment of women’s psycho-physical well-being. Thanks to enlightened scientists such as Professor Umberto Veronesi, breast cancer surgery has since impressively progressed and adopted a much more conservative approach. Over the last three decades, a better understanding of tumor biology and of its significant biomarkers has made the assessment of genetic and molecular profiles increasingly important. At the same time, neo-adjuvant treatments have been introduced, and great improvements in genetics, imaging technologies and in both oncological and reconstructive surgical techniques have been made. The future of breast cancer management must now rest on an ever more precise and targeted type of surgery that, through an increasingly multidisciplinary and personalized approach, can ensure oncological radicality while offering the best possible quality of life.

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“…However, patients with moderate and/or severe breast ptosis are usually not eligible for this classic surgical approach for NSM. Different patterns for skin incisions are classified as hemi-periareolar, round block, vertical pattern and wise pattern approaches [73]. The selection criteria for NSMs include: no areolar or nipple retraction; no nipple discharge-containing blood; no inflammatory disease and negative intraoperative retroareolar margins on frozen sections.…”

Section: Mastectomymentioning

confidence: 99%

Multicentric breast cancer with heterogeneous histopathology: a multidisciplinary review

et al. 2020

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Multiple synchronous (multifocal or multicentric) ipsilateral breast cancers with heterogeneous histopathology are a rare clinical occurrence, however, their incidence is increasing due to the use of MRI for breast cancer screening and staging. Some studies have demonstrated poorer clinical outcomes for this pattern of breast cancer, but there is no evidence to guide clinical practice. In this multidisciplinary review, we reflect on pathology and molecular characteristics, imaging findings, surgical management including conservation and reconstructive options and approach to the axilla, and the role of chemotherapy and radiotherapy. Multidisciplinary discussions appear decisive in planning an appropriate surgical choice and defining the correct systemic treatment tailored to each clinical condition.

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Nipple-sparing mastectomy with different approaches: surgical incisions, complications, and cosmetic results. Preliminary results of 100 consecutive patients at a single center

Cited by 22 publications

References 25 publications

Hereditary Gastric and Breast Cancer Syndromes Related to CDH1 Germline Mutation: A Multidisciplinary Clinical Review

Hereditary Gastric and Breast Cancer Syndromes Related to CDH1 Germline Mutation: A Multidisciplinary Clinical Review

Breast Cancer Surgery: New Issues

Multicentric breast cancer with heterogeneous histopathology: a multidisciplinary review

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