Outcomes after Total Skin-sparing Mastectomy and Immediate Reconstruction in 657 Breasts

Abstract

In this large, high-risk cohort, TSSM was associated with low rates of NAC complications, nipple involvement, and locoregional recurrence.

Immediate nipple-areola-sparing mastectomy reconstruction: An update on oncological and reconstruction techniques

“…The satisfactory results are due to a close collaboration with the oncological surgical ed the technique for benign diseases, however he did not report the procedure for oncological objectives or as a risk-reduction alternative [10,11] . Recently, there has been an increase in clinical experience studies of NSM for breast cancer prophylaxis or early cancer treatment, evidencing revived interest in this surgical procedure [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][33][34][35][36][37][38][39][40][41][42][43][44] . In fact, there is evidence that NSM provides aesthetic advantages, with reduced need for further surgery and NAC reconstruction [15,17,[20][21][22]29,[33][34][35][36][37][38][39]…”

“…Utilizing the breast skin envelope optimizes the contour of the breast, resulting in a satisfactory aesthetic outcome and minimizing scarring and post-mastectomy deformity [6][7][8][9] . Recently, an argumentation has advanced about the opportunity of extending conservation of the skin to include the NAC [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] . In fact, although breast reconstruction following SSM may offer aesthetic advantages over mastectomy, removal of the NAC significantly impacts on the aesthetic outcome.…”

“…In addition, to date there have been no controlled clinical trials evaluating the oncological effectiveness of nipple-sparing mastectomy (NSM) vs traditional SSM surgery. In spite of the controversies involving risk of local relapse, some current clinical studies have shown that the NSM is a safe procedure for selected cases [11,[14][15][16]18,[23][24][25][26][27]29,30,[33][34][35][36][37][38][39]44,47,48] .…”

Nipple-sparing mastectomy in breast cancer patients: The role of adjuvant radiotherapy (Review)

“…In 11 studies, the inclusion criterion for NSM was small tumors >1-2 cm distant from the NAC (1,33). In 21 studies, locally advanced and multi-centric tumors were included (4,34,35). Only 5 studies excluded T3/4 tumors and patients with ≥4 positive lymph nodes.…”

Breast reconstruction following prophylactic or therapeutic mastectomy for breast cancer: Recommendations from an evidence-based provincial guideline

“…A prospectively maintained database of patients (n=428) undergoing nipple-sparing mastectomy with immediate breast reconstruction for in situ cancer (16.9%), invasive cancer (45.8%) or prophylactic risk-reduction (37.3%) revealed a locoregional recurrence rate of 2% overall (median follow-up 28 months) and 2.4% among those with at least three years' follow-up (median follow-up 45 months). Nipple tissue contained in situ cancer in 11 (1.7%) breasts and invasive cancer in nine (1.4%) (89). In a separate study, at 22.5 months, no local or regional recurrences were apparent in 45 prophylactic and 53 therapeutic mastectomies, among patients with tumours ≤3 cm in size and ≥2 cm from the nipple, no clinical invasion of the nipple-areola, no multicentric disease, negative intraoperative retroareolar frozen section and no nodal disease (90).…”