The oncological safety of nipple-sparing mastectomy – A Swedish matched cohort study

Adam, H.; Bygdeson, M.; Boniface, Jana de

doi:10.1016/j.ejso.2014.07.037

Cited by 76 publications

(87 citation statements)

References 29 publications

(19 reference statements)

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“…Table summarizes the published studies concerning the oncological safety of NSM with immediate breast reconstruction. The LRR is approximately 0%‐11% in most series . These results are similar to the rates of loco‐regional recurrence after skin‐sparing or conventional mastectomy .…”

Section: Discussionsupporting

confidence: 67%

Oncologic safety of nipple‐sparing mastectomy in patients with short tumor‐nipple distance

et al. 2019

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Background There is a tendency to avoid nipple‐sparing mastectomy (NSM) when a tumor‐nipple distance (TND) is <2 cm due to the risk of occult nipple involvement. The purpose of the study was to determine whether the patients who undergo NSM with immediate reconstruction are oncologically safe when TND is <2 cm. Methods Patients who underwent NSM followed by immediate reconstruction for breast cancer were retrospectively analyzed. Patients who are negative for nipple‐base in either frozen‐section or paraffin histopathology were included. MRI was used to obtain TNDs to compare local‐recurrence‐free and disease‐free survival in group I (TND <2 cm) and group II (TND ≥2 cm). Disease‐free survival rates were determined to assess the outcome. Results Of the 214 cases with malignancy on MRI, 21 cases diagnosed with pure ductal carcinoma in situ were excluded. Among the 193 NSM cases diagnosed with invasive cancer, TND was <2.0 cm in 59 (30.56%) cases and ≥2.0 cm in 134 (69.43%) cases. No significant differences were found between groups in regards to ER, PR, HER2‐neu status, and nodal involvement (P = 0.34, P = 0.41, P = 0.54, and P = 0.12 respectively). In a median follow‐up time of 62 months (range; 13‐114), patients in group I had four local recurrences, whereas group II was found to have five local and three distant metastases. No significant differences were observed between groups concerning disease‐free survival (10‐year DFS 93.2% vs 96.3%; P = 0.368 respectively). Conclusions Patients who have invasive cancer diagnosis with a TND <2 cm are eligible to undergo therapeutic NSM with immediate reconstruction.

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Section: Discussionsupporting

confidence: 67%

Oncologic safety of nipple‐sparing mastectomy in patients with short tumor‐nipple distance

et al. 2019

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“…Limitations of this study include its retrospective nature, power, and follow‐up time. However, the number of patients (141) and breasts (211) undergoing NSM with available long‐term follow‐up data is comparable to previous studies examining oncologic safety with this relatively new procedure, which range from 67 to 370 patients and 69 to 645 breasts, respectively . Additionally, while other studies do not specifically address pathologic cancer stage, our proportion of patients undergoing mastectomy for therapeutic indication, with nodal disease, and with locally advanced disease compares favorably with other studies .…”

Section: Discussionsupporting

confidence: 66%

Oncologic outcomes after nipple‐sparing mastectomy: A single‐institution experience

Frey

Alperovich

Kim

et al. 2015

Journal of Surgical Oncology

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“…In addition to formal multi-disciplinary breast cancer care, all patients are now seen by subspecialty breast surgeons who occupy a common clinic facility with breast reconstructive surgeons. These factors, and the availability of robust data on the oncological safety of SSM and NSM in recent years, likely contributed to an increase in patients being referred for post-mastectomy reconstructions (3,(16)(17)(18). This parallels the observation that patients treated at specialized cancer centers, like those recognized by the National Cancer Institute in the USA, are reported to be 40% more likely to undergo reconstruction after mastectomy than patients treated at other institutions (19,20).…”

Section: Discussionmentioning

confidence: 98%

Trends in Post-Mastectomy Reconstruction in an Asian Population: A 12-Year Institutional Review

Tan

Goh

et al. 2016

Breast J

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Post-mastectomy breast reconstruction is an integral component of breast cancer treatment. It is often perceived that women in Asian countries have a lower rate of post-mastectomy reconstruction than Western populations. This study describes trends in timing and types of breast reconstruction performed in the largest healthcare provider in Singapore, over a period of 12 years. It also reports on the oncological outcomes and surgical safety. A retrospective review of all patients who underwent post-mastectomy reconstruction from January 2001 to December 2012 at the National Cancer Centre Singapore and Singapore General Hospital was performed. Six hundred and twenty post-mastectomy reconstructions were performed in 579 patients. The proportion of reconstructions increased from 4% in 2001 to 18% in 2012. Younger patients (<50 years old) and those with early stage cancer were more likely to undergo reconstruction. Immediate breast reconstruction was favored by more than 90% of patients. Postoperatively, 9% developed acute surgical complications that were treated surgically; 6% had additional surgery for late complications. Only 4% had delay of adjuvant chemotherapy. At median follow-up of 63 months (range 3-166), loco-regional recurrence was 4%, and distant metastases 8%. Post-mastectomy reconstruction for breast cancer is increasingly performed in our institution. Both younger age and lower stage disease were associated with choice for reconstruction in our study. Low rates of delay to adjuvant therapy were noted, and it may safely be offered to suitable women undergoing mastectomy.

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The oncological safety of nipple-sparing mastectomy – A Swedish matched cohort study

Cited by 76 publications

References 29 publications

Oncologic safety of nipple‐sparing mastectomy in patients with short tumor‐nipple distance

Oncologic safety of nipple‐sparing mastectomy in patients with short tumor‐nipple distance

Oncologic outcomes after nipple‐sparing mastectomy: A single‐institution experience

Trends in Post-Mastectomy Reconstruction in an Asian Population: A 12-Year Institutional Review

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