Outcome Evaluation after 2023 Nipple-Sparing Mastectomies: Our Experience

Vita, Roy De; Zoccali, Giovanni; Buccheri, Ernesto Maria; Costantini, Maurizio; Botti, Claudio; Pozzi, Marcello

doi:10.1097/prs.0000000000003027

Cited by 56 publications

(55 citation statements)

References 61 publications

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“…In the present study, the choice of the incision did not have influence on the rate of complications (23). Smoking was associated with an increased risk of complications.…”

Section: Discussioncontrasting

confidence: 40%

Early postoperative complications and local relapses after nipple sparing mastectomy and immediate breast reconstruction using silicone implants

et al. 2019

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Purpose: Purpose of this study was to evaluate early complications and risk factors associated with nipple sparing mastectomy and immediate breast reconstruction. Methods: This retrospective study was made using data from 246 breast cancer patients treated at the Oncology Institute of Vojvodina in the period from January 2010 to December 2015. In all patients nipple sparing mastectomy was performed along with primary breast reconstruction. Results: The mean indication for nipple sparing mastectomy was multicentricity of the tumor (114 patients; 46.3%). The majority of surgically treated patients were in stage II of the disease. The total percentage of local relapses after the nipple sparing mastectomy was 1.6% (4 patients). Total percentage of early complications was 15% (37 patients). Median follow-up after nipple sparing mastectomy was 260 weeks (ranging from 417 to 104 weeks). Conclusion: Primary reconstruction of the breasts using heterologous implants is standard surgical procedure for breast cancer that does not lead to increased number of complications, nor to increased percentage of the local recurrence.

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“…In the present study, the choice of the incision did not have influence on the rate of complications (23). Smoking was associated with an increased risk of complications.…”

Section: Discussioncontrasting

confidence: 40%

Early postoperative complications and local relapses after nipple sparing mastectomy and immediate breast reconstruction using silicone implants

et al. 2019

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“…As consequence, the recent trends are to move the access far from the breast footprint in the search for the ideal incision for NSM. [5][6][7][8][9][10][11][12] We believe that the ideal NSM incision is the axillary one as this single access allows to perform a safe nonendoscopic mastectomy in cup A and B breasts, sentinel node biopsy/axillary clearance, and nonendoscopic immediate prepectoral reconstruction when feasible (ie thick skin flaps) or endoscopic submuscular-subfascial direct-toimplant reconstruction, with the main advantage of a hidden and well-concealed scar. In our experience, a 6-cm incision located on the lowest axillary fold along the mid-axillary line allows to perform a safe nonendoscopic mastectomy, node surgery, and direct-to-implant reconstruction both submuscular and prepectoral.…”

Section: Discussionmentioning

confidence: 99%

“…Nipple‐sparing mastectomy (NSM) has known an exponential diffusion worldwide for prophilaxis and therapeutic mastectomies in selected candidates, being oncologically safe and improving reconstructive outcomes and patients' satisfaction. The two most common skin incisions are the radial and Inframammary fold ones, which represent an imperfect solution between the oncologic/reconstructive needs and the cosmetic outcomes (scar visibility) …”

Section: Introductionmentioning

confidence: 99%

“…The two most common skin incisions are the radial and Inframammary fold ones, which represent an imperfect solution between the oncologic/reconstructive needs and the cosmetic outcomes (scar visibility). [1][2][3][4][5][6] The aim of this work was to give insights on our surgical technique with axillary approach, which allows to perform the NSM, axillary node surgery, and direct-to-implant reconstruction using only the axillary incision.…”

Section: Introductionmentioning

confidence: 99%

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Nipple‐sparing mastectomy combined with endoscopic immediate reconstruction via axillary incision for breast cancer: A preliminary experience of an innovative technique

et al. 2019

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Introduction Nipple‐sparing mastectomy (NSM) has known an exponential diffusion worldwide for prophilaxis and therapeutic mastectomies in selected candidates, being oncologically safe and improving reconstructive outcomes and patients' satisfaction. The two most common used skin incisions are the radial and inframammary fold ones, which represent an imperfect aesthetic solution. The aim of this work was to give insights on our surgical technique, which allows to perform the NSM, node surgery, and endoscopic direct‐to‐implant reconstruction using a cosmetic axillary incision. Materials and methods Between June 2016 and January 2019, 7 consecutive patients underwent NSM, lymph node surgery and endoscopic direct‐to‐implant reconstruction using a small cosmetic axillary incision for breast cancer treatment in a single Institution. An operative rigid endoscope with working channel (Richard Wolf) was used to dissect the entire submuscular‐subfascial pocket. The mean age of the patients was 42.8 years old (range: 36‐49 years). The evaluation methods were clinical and photography‐based assessments, as well as the BREAST‐Q which was used to quantify patient satisfaction. Results The average follow‐up time was 9 months (range 3‐22 months). Tumor‐free margins were obtained in all cases. No tumor recurrence or metastasis occurred during follow‐up. No major complications were experienced. There were no cases of malposition, wrinkling, or rippling. All patients were satisfied with their esthetic results, especially the absence of visible scars. Conclusions From our preliminary experience, NSM combined with endoscopic immediate reconstruction via axillary incision for breast cancer treatment seems to be a promising new procedure in cup A and B breasts alternative to the conventional techniques, as it allowed to have safe and pleasant aesthetic and oncologic outcomes.

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“…Given the variable nature of the location, thickness, and macroscopic appearance of this encapsulating breast fascia, great care must be taken intraoperatively to ensure that this proper plane is established and maintained throughout the mastectomy procedure. 47 …”

Section: Discussionmentioning

confidence: 99%

Mastectomy Flap Thickness and Complications in Nipple-Sparing Mastectomy: Objective Evaluation using Magnetic Resonance Imaging

Frey

Salibian

Choi

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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Background:Ischemic complications after nipple-sparing mastectomy (NSM) have been associated with numerous variables. However, the impact of NSM flap thickness has been incompletely evaluated.Methods:NSM flap thickness was determined for all NSMs from 2006 to 2016 with available pre- or postoperative breast magnetic resonance imaging (MRIs). Demographics and outcomes were stratified by those with and without ischemic complications.Results:Of 1,037 NSM reconstructions, 420 NSMs had MRI data available, which included 379 preoperative MRIs and 60 postoperative MRIs. Average total preoperative skin/subcutaneous tissue NSM flap thickness was 11.4 mm. Average total postoperative NSM flap thickness was 8.7 mm. NSMs with ischemic complications were found to have significantly thinner overall postoperative NSM flap thickness compared with those without ischemic complications (P = 0.0280). Average overall postoperative NSM flap thickness less than 8.0 mm was found to be an independent predictor of ischemic complications (odds ratio, 6.5263; P = 0.026). In NSMs with both pre- and postoperative MRIs, the overall average postoperative NSM flap thickness was 68.2% of preoperative measurements. Average overall postoperative NSM flap thickness was significantly less than average overall preoperative NSM flap thickness (P < 0.0001). NSMs with ischemic complications were found to have a significantly lower ratio of overall postoperative to preoperative flap thickness (52.0% versus 74.0%; P < 0.0001).Conclusions:Ischemic complications after NSM are significantly associated with thinner postoperative NSM flap thickness. Particularly, NSM flap thickness less than 8.0 mm is a positive independent predictor of ischemic complications. The ratio of postoperative to preoperative NSM flap thickness was significantly lower in reconstructions with ischemic complications.

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Outcome Evaluation after 2023 Nipple-Sparing Mastectomies: Our Experience

Abstract: Therapeutic, III.

Cited by 56 publications

References 61 publications

Early postoperative complications and local relapses after nipple sparing mastectomy and immediate breast reconstruction using silicone implants

Early postoperative complications and local relapses after nipple sparing mastectomy and immediate breast reconstruction using silicone implants

Nipple‐sparing mastectomy combined with endoscopic immediate reconstruction via axillary incision for breast cancer: A preliminary experience of an innovative technique

Mastectomy Flap Thickness and Complications in Nipple-Sparing Mastectomy: Objective Evaluation using Magnetic Resonance Imaging

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