Radiotherapy and nipple–areolar complex necrosis after nipple-sparing mastectomy: a systematic review and meta-analysis

2016 ◽  
Vol 122 (3) ◽  
pp. 171-178 ◽  
Author(s):  
Yajuan Zheng ◽  
Miaochun Zhong ◽  
Chao Ni ◽  
Hongjun Yuan ◽  
Jingxia Zhang
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Nipple Areolar Complex ◽  
Areolar Complex ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Systematic Review and Meta-analysis of Complications Following Mastectomy and Prosthetic Reconstruction in Patients With and Without Prior Breast Augmentation

2021 ◽  
Author(s):  
Maria Chicco ◽  
Ali R Ahmadi ◽  
Hsu-Tang Cheng
Keyword(s):  
Systematic Review ◽  
Postoperative Complications ◽  
Meta Analysis ◽  
Skin Flap ◽  
Prosthetic Reconstruction ◽  
Hematoma Formation ◽  
Significant Difference ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing ◽  
Early Late

Abstract Background There is limited evidence available in literature with regard to the complication profile of mastectomy and immediate prosthetic reconstruction in augmented patients. Objectives The purpose of this systematic review and meta-analysis is to compare postoperative complications between women with versus without prior augmentation undergoing skin- or nipple-sparing mastectomy and immediate prosthetic reconstruction. Methods A systematic search was conducted in February 2020 for studies comparing women with versus without prior augmentation undergoing skin- or nipple-sparing mastectomy and immediate prosthetic reconstruction with documentation of postoperative complications. Outcomes analyzed included early, late and overall complications. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were obtained through meta-analysis. Results Our meta-analysis, which included six studies comparing 241 breasts with prior augmentation and 1441 without, demonstrated no significant difference between the two groups in rates of early (36.7% vs. 24.8%; OR=1.57, 95% CI 0.94 to 2.64; P=0.09), late (10.1% vs. 19.9%; OR=0.53, 95% CI 0.06 to 4.89; P=0.57) and overall complications (36.5% vs. 31.2%; OR=1.23, 95% CI 0.76 to 2.00; P=0.40). Subgroup analysis showed a significantly higher rate of hematoma formation in the augmented group (3.39% versus 2.15%; OR=2.68, 95% CI 1.00 to 7.16; P=0.05), but no difference in rates of seroma, infection, mastectomy skin flap necrosis and prosthesis loss. Conclusions Our meta-analysis suggests that prior augmentation does not significantly increase overall postoperative complications in women undergoing skin- or nipple-sparing mastectomy and immediate prosthetic reconstruction. However, the significantly higher rate of hematoma formation in augmented patients warrants further investigation and preoperative discussion.

scholarly journals Immediate breast reconstruction following nipple-sparing mastectomy in an Asian population: Aesthetic outcomes and mitigating nipple-areolar complex necrosis

2018 ◽  
Vol 45 (3) ◽  
pp. 229-238 ◽  
Author(s):  
Wan-Sze Pek ◽  
Bien-Keem Tan ◽  
Yvonne Ying Ru Ng ◽  
Veronique Kiak Mien Tan ◽  
Mohamed Zulfikar Rasheed ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Asian Population ◽  
Immediate Breast Reconstruction ◽  
Nipple Areolar Complex ◽  
Areolar Complex ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Comparison of terminal duct lobular units in the nipple areolar complex by tumor subtypes-the implication for nipple sparing mastectomy.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12082-e12082
Author(s):  
Kenna Schnarr ◽  
Fang Fan ◽  
Amanda Leigh Amin ◽  
Christa Balanoff ◽  
Joshua Mammen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Statistical Significance ◽  
Breast Cancer Subtype ◽  
Tumor Subtype ◽  
Luminal B ◽  
Nipple Areolar Complex ◽  
Areolar Complex ◽  
Significant Difference ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

e12082 Background: Nipple-sparing mastectomy (NSM) has gained popularity for surgical treatment of breast cancer. Terminal duct lobular units (TDLU) have been shown to be present in 25% of nipple areolar complex (NAC). Pathologic tumor subtype influence on presence of TDLU in the NAC has not been assessed. In addition, criteria for technically performing the dissection below the NAC have not been established. We sought to evaluate TDLU characteristics by tumor subtype and determine NSM dissection criteria below the NAC. Methods: A retrospective review was performed of 120 total and skin sparing mastectomies, 30 of each breast cancer subtype, from 1/2013 to 1/2015. The NAC of each mastectomy was assessed for number of TDLU and distance from TDLU to the skin. Results: Thirty of the 120 mastectomies (25%) had TDLU present below the NAC. Of the 30 with TDLU, there was no statistically significant difference in number of TDLU present based on tumor grade (gd) (gd 1 vs 2, p = .67; gd 1 vs 3, p = .24). Compared to luminal A, luminal B showed statistical significance (p < .05) for number of TDLU at the NAC whereas Her 2 and triple negative breast cancer (TNBC) were not statistically significant (p = .09 and .10). In mastectomies with TDLU present, gd 2 (p < .05) and gd 3 (p = .05) had a closer skin distance than gd 1. When compared by tumor subtype, there was no difference in TDLU to skin distance (table). Conclusions: NSM has been adopted as a safe oncologic approach to breast cancer treatment. Although presence of TDLU in luminal B subtype was statistically significant, this may not be clinically significant, as there were only 2 of 30 cases with TDLU. Our study indicates that a careful dissection at the level of the dermis below the NAC is necessary, as 25% of women will have TDLU present. This will provide an appropriate oncologic outcome similar to total and skin sparing mastectomy. Tumor subtype does not appear to be exclusion criteria for NSM. However, more aggressive dissection may be necessary to clear all TDLU from below the NAC in higher gd cancers. [Table: see text]

Nipple-areolar complex ischemia and necrosis in nipple-sparing mastectomy

2018 ◽  
Vol 44 (8) ◽  
pp. 1170-1176 ◽  
Author(s):  
Sung Jae Ahn ◽  
Tae Yong Woo ◽  
Dong Won Lee ◽  
Dae Hyun Lew ◽  
Seung Yong Song
Keyword(s):  
Nipple Areolar Complex ◽  
Areolar Complex ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Areola sparing mastectomy without preservation of nipple: A clinicopathological assessment and a case series.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12099-e12099
Author(s):  
Houpu Yang ◽  
Shu Wang ◽  
Fei Xie ◽  
Jiajia Guo ◽  
Xiaoyong Chen ◽  
...  
Keyword(s):  
Case Series ◽  
Recurrence Risk ◽  
Nipple Reconstruction ◽  
Potential Treatment ◽  
Oncological Safety ◽  
Nipple Areolar Complex ◽  
Areolar Complex ◽  
Immediate Implant ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

e12099 Background: Preservation of the nipple-areolar complex has gained worldwide popularity due to significantly improved cosmetic result of mastectomy, while 4% to 58% involvement of nipple and assumed increased recurrence risk made it controversial on the oncological safety of nipple sparing mastectomy. This study focuses on the oncological feasibility of areola sparing mastectomy without preservation of nipple by evaluating involvement of the areola and nipple separately in consecutive mastectomy specimens. Methods: During Aug 3, 2016 to Jan 25, 2017, consecutive specimens from women underwent traditional mastectomy were analyzed. Areolae and nipples were resected and sectioned separately. Involvement of nipple and areola and clinicopathological data were analyzed. The results of 4 patients underwent areola sparing mastectomy were studied. Results: The overall frequency of malignant involvement of the areola among the breasts was 3 of 127 (2.3%), which was significantly lower than that of the nipple (11 of 127, 8.7%, p = 0.03). In patients whose tumors were ≤3cm, outside areolar area, and without dimpling of areola or inflammatory appearance, the incidence of areolar involvement was low to zero. A total of 4 patients received areola sparing mastectomy by “nipple coring” and immediate implant based reconstruction. No patients desired nipple reconstruction. Cosmetic results were all good. Conclusions: Areolae were rarely involved in breasts with tumor ≤3cm, and without inflammatory skin, dimpling of areola or retro-areolar tumor. Areola sparing mastectomy might be oncologically safe and should be a potential treatment in selected patients.

Is There a Preferred Incision Location for Nipple-Sparing Mastectomy? A Systematic Review and Meta-Analysis

2019 ◽  
Vol 143 (5) ◽  
pp. 906e-919e ◽  
Author(s):  
David A. Daar ◽  
Salma A. Abdou ◽  
Lauren Rosario ◽  
William J. Rifkin ◽  
Pauline J. Santos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Incision Location ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing
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