Oncological safety of therapeutic ‘nipple-sparing mastectomy’ followed by reconstruction: a systematic review

Blanckaert, M.; Vranckx, Jan

doi:10.1080/00015458.2021.1922829

Cited by 8 publications

(4 citation statements)

References 37 publications

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“…5 A recent systematic review found locoregional recurrence rates for nipple-sparing mastectomy at median 5-year follow up to be 0 to 7.4 percent. 19 With 7-year median follow-up, Wu and colleagues report a locoregional recurrence rate of 3.5 percent, comparable to the rate described in our cohort. 20 Li and associates examined 763 patients from the Surveillance, Epidemiology, and End Results database with a mean 5.7-year follow-up.…”

Section: Discussionsupporting

confidence: 86%

Long-Term Cancer Recurrence Rates following Nipple-Sparing Mastectomy: A 10-Year Follow-Up Study

Boyd

Salibian

Bekisz

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Despite the increased use of nipple-sparing mastectomies, there are limited data examining long-term cancer recurrence rates in these patients. The objective of this study was to analyze breast cancer recurrence in patients who underwent therapeutic nipple-sparing mastectomy with a median of 10 years of follow-up. Methods: All patients undergoing nipple-sparing mastectomy at a single institution were retrospectively reviewed temporally to obtain a median of 10 years of follow-up. Patient demographic factors, mastectomy specimen pathologic findings, and oncologic outcomes were analyzed. Univariate analysis was performed to identify independent risk factors for locoregional recurrence. Results: One hundred twenty-six therapeutic nipple-sparing mastectomies were performed on 120 patients. The most frequently observed tumor histology included invasive ductal carcinoma (48.4 percent) and ductal carcinoma in situ (38.1 percent). Mean tumor size was 1.62 cm. Multifocal or multicentric disease and lymphovascular invasion were present in 31.0 percent and 10.3 percent of nipple-sparing mastectomy specimens, respectively. Sentinel lymph node biopsy was performed in 84.9 percent of nipple-sparing mastectomies, and 17.8 percent were positive. The rate of positive frozen subareolar biopsy was 7.3 percent (n = 82) and that of permanent subareolar pathology was 9.5 percent (n = 126). The most frequently observed pathologic tumor stages were stage I (44.6 percent) and stage 0 (33.9 percent). The incidence of recurrent disease was 3.17 percent per mastectomy and 3.33 percent per patient. On univariate analysis, no demographic, operative, or tumor-specific variables were independent risk factors for locoregional recurrence. Conclusions: Overall recurrence rates are low in patients undergoing nipple-sparing mastectomy at a median follow-up of 10-years. Close surveillance should remain a goal for patients and their providers to promptly identify potential recurrence. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.

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Section: Discussionsupporting

confidence: 86%

Long-Term Cancer Recurrence Rates following Nipple-Sparing Mastectomy: A 10-Year Follow-Up Study

Boyd

Salibian

Bekisz

et al. 2022

Plastic &Amp; Reconstructive Surgery

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“…In a recent systematic review, locoregional recurrence was found to be 0%-7.4% after a median 5-year follow-up and no increased risk of recurrence with reconstructive method[ 45 ]. In a 7-year median follow-up study, locoregional recurrence in patients with immediate breast reconstruction was found to be 3.5% and independent from the reconstructive method[ 46 ].…”

Section: Implant-based Reconstructionmentioning

confidence: 99%

Breast reconstruction: Review of current autologous and implant-based techniques and long-term oncologic outcome

Malekpour¹,

Malekpour²,

Wang³

2023

World J Clin Cases

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Implant-based reconstruction is the most common method of breast reconstruction. Autologous breast reconstruction is an indispensable option for breast reconstruction demanding keen microsurgical skills and robust anatomical understanding. The reconstructive choice is made by the patient after a discussion with the plastic surgeon covering all the available options. Advantages and disadvantages of each technique along with long-term oncologic outcome are reviewed.

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“…Several studies with long follow up have demonstrated the oncological safety of SSM [ 7 , 8 , 9 , 10 , 11 , 12 , 13 ]. As surgical innovation has progressed, preservation of the nipple as part of the native skin of the breast, known as nipple-sparing mastectomy (NSM), has become acceptable from an oncologic perspective [ 14 , 15 , 16 ]. Galimberti et al [ 17 ] reviewed 1989 patients who had undergone NSM as a therapeutic procedure.…”

Section: Introductionmentioning

confidence: 99%

Satisfaction with Long-Term Aesthetic and 10 Years Oncologic Outcome following Risk-Reducing Mastectomy and Implant-Based Breast Reconstruction with or without Nipple Preservation

O’Connell

Tasoulis

Hristova

et al. 2022

Cancers

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Incidence of bilateral risk-reducing mastectomies (RRMs) is increasing. The aim of this study was to compare satisfaction, aesthetic and oncological outcomes in women undergoing RRM with implant-based reconstruction comparing nipple-sparing mastectomy (NSM) with skin-sparing mastectomy (SSM) (sacrificing the nipple +/− nipple reconstruction). Women who had undergone bilateral RRM between 1997 and 2016 were invited. Aesthetic outcome and nipple symmetry were evaluated using standardized anthropometric measurements. The oncological outcome was assessed at last documented follow up. Ninety-three women (186 breasts) participated, 60 (64.5%) had NSM, 33 (35.5%) SSM. Median time between surgery and participation was 98.4 months (IQR: 61.7–133.9). Of the women, 23/33 (69.7%) who had SSM underwent nipple reconstruction. Nipple projection was shorter in the reconstructed SSM group than the maintained NSM group (p < 0.001). There was no significant difference in overall symmetry (p = 0.670), satisfaction regarding nipple preservation (p = 0.257) or overall nipple satisfaction (p = 0.074). There were no diagnoses of breast cancer at a median follow up of 129 months (IQR: 65–160.6). Women who undergo nipple-sparing RRM maintain long-term nipple symmetry. Nipple projection was less maintained after nipple reconstruction. Although satisfaction with the nipples was higher in the NSM group, this did not reach statistical significance. No breast cancers developed after RRM with long-term follow up.

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Oncological safety of therapeutic ‘nipple-sparing mastectomy’ followed by reconstruction: a systematic review

Cited by 8 publications

References 37 publications

Long-Term Cancer Recurrence Rates following Nipple-Sparing Mastectomy: A 10-Year Follow-Up Study

Long-Term Cancer Recurrence Rates following Nipple-Sparing Mastectomy: A 10-Year Follow-Up Study

Breast reconstruction: Review of current autologous and implant-based techniques and long-term oncologic outcome

Satisfaction with Long-Term Aesthetic and 10 Years Oncologic Outcome following Risk-Reducing Mastectomy and Implant-Based Breast Reconstruction with or without Nipple Preservation

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