scholarly journals Local Recurrence in the Nipple-Areola-Complex After Nipple-Sparing Mastectomy and Skin-Sparing Mastectomy With Immediate Breast Reconstruction

2020 ◽  
Vol 32 (3) ◽  
Author(s):  
Wan Yu Huang
Keyword(s):  
Local Recurrence ◽  
Breast Reconstruction ◽  
Immediate Breast Reconstruction ◽  
Nipple Areola Complex ◽  
Areola Complex ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

scholarly journals Skin Sparing Mastectomy with Preservation of Nipple Areola Complex and Immediate Breast Reconstruction in Patients with Breast Cancer: A Single Centre Prospective Study

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Debarati Chattopadhyay ◽  
Souradip Gupta ◽  
Prabir Kumar Jash ◽  
Marang Buru Murmu ◽  
Sandipan Gupta
Keyword(s):  
Breast Cancer ◽  
Patient Satisfaction ◽  
Local Recurrence ◽  
Breast Reconstruction ◽  
Frozen Section ◽  
Immediate Breast Reconstruction ◽  
Breast Cancer Patients ◽  
Nipple Areola Complex ◽  
Areola Complex ◽  
The Aesthetic

Background. Skin and nipple areola sparing mastectomy (NASM) has recently gained popularity as the management of breast cancer. This study aims to evaluate the aesthetic outcome, patient satisfaction, and oncological safety of NASM. Methods. The study prospectively analyzes the results of NASM and immediate breast reconstruction in 34 women with breast cancer. The criteria for inclusion were core biopsy-proven, peripherally located breast cancer of any tumor size and with any “N” status, with documented negative intraoperative frozen section biopsy of retroareolar tissue, and distance from the nipple to tumor margin >2 cm on mammography. Results. The median age of the patients was 45 years. The majority had either stage II or stage III breast cancer. The median mammographic distance of tumor from nipple areola complex (NAC) was 3.8 cm. The overall operative morbidity was minimal. The NAC could be preserved in all the patients. There was no local recurrence of tumor at median follow-up of 28.5 months. The aesthetic outcomes were satisfactory. Conclusion. NASM and immediate breast reconstruction can be successfully achieved with minimal morbidity and very low risk of local recurrence in appropriately selected breast cancer patients, with acceptable aesthetic results and good patient satisfaction.

Nipple-sparing mastectomy and immediate breast reconstruction: Critical appraisal of five-year, single-center outcomes.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 99-99
Author(s):  
D. Westbroek ◽  
K. Mann ◽  
M. Ho ◽  
I. Gukas ◽  
I. Karat ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Patient Selection ◽  
Disease Free Survival ◽  
Immediate Breast Reconstruction ◽  
Tissue Loss ◽  
Free Survival ◽  
Areola Complex ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing ◽  
Disease Free

99 Background: Approximately 5,000 patients undergo breast reconstruction annually in the United Kingdom (2:1 ratio of immediate versus delayed respectively). Preservation of the breast envelope, i.e., skin and nipple areola complex (NAC) improves cosmesis. While skin-sparing mastectomy is an accepted modality for local control in appropriately selected patients, nipple-sparing mastectomy (NSM) remains controversial. In over 1,800 published NSM cases, the local event rate attributable to NAC preservation following NSM (therapeutic and prophylactic) is 0.16% with no evidence of deleterious impact on disease-free survival. In our cohort, patient selection criteria included: preoperative lesion characterisation; 5-mm margin acceptance; submission of separate nipple core specimens for paraffin block histological assessment and re-excision of all involved margins. This study is intended to evaluate the efficacy of loco-regional control in a consecutive cohort of patients, under uniform conditions undergoing nipple-sparing mastectomy and immediate breast reconstruction. We highlight the surgical technique used and propose in/exclusion criteria for appropriate patient selection. Methods: 84 consecutive patients underwent NSM and IBR at Frimley Park Hospital, Surrey, UK (IJL, RD) between January 2004 and December 2008. Data was accrued retrospectively from the institution’s clinical coding, electronic records, and WinPath database. Endpoints recorded include: the incidence of (occult) malignancy at the nipple margins; NAC subcutaneous tissue loss; local (NAC) recurrence rates and disease free survival. Results: The mean age was 51.1 years and follow-up 4.9 years. There was one case of local recurrence in a patient who declined re-excision of close/involved margins. The immediate peri-operative complication rate was within the national mastectomy breast reconstruction audit outcome guidelines. Conclusions: In appropriately selected patients, our findings support nipple preservation at the time of mastectomy and immediate reconstruction as this enhances the cosmetic outcome without compromising oncologic safety.

scholarly journals Evaluation of result of skin-nipple sparing mastectomy in Baghdad Teaching Hospital and Dijla Private Hospital

2018 ◽  
Vol 5 (9) ◽  
pp. 3002
Author(s):  
Sabah Noori Abdulraheem Al-Khazaali ◽  
Rafea Jasim Hussein Al-Shammari
Keyword(s):  
Local Recurrence ◽  
Breast Reconstruction ◽  
Immediate Breast Reconstruction ◽  
Clinical Feature ◽  
Characteristic Type ◽  
Aesthetic Result ◽  
Nipple Sparing Mastectomy ◽  
One Year ◽  
Nipple Sparing

Background: Skin-nipple sparing mastectomy and immediate breast reconstruction by silicone implantation has become increasingly popular as an effective treatment for patients with breast carcinoma. The aim of this study was to evaluate the results of skin-nipple sparing mastectomy.Methods: Records of twenty-seven patients with operable breast cancer who had skin-nipple sparing mastectomy and immediate breast reconstruction between June 2009 and June 2011 were reviewed. Patients and tumor characteristic, type of reconstruction, post-operative complication, aesthetics, results and incidence of recurrence analyzed.Results: Mean age of 37 patients, aged 25 to 48 years old. Regarding the clinical feature, the size of mass <3 cm in 70%, the site of mass in upper outer quadrant in 62%, no case of skin changes and/or nipple changes. There are two cases of all patients which fixed to underlying tissues about 63% of cases are grade II, stage II and 37% are grade I, stage I. The results of follow up of the procedures are: seroma developed in 14%, infection 3.5%, skin necrosis 7%, local recurrence was zero for follow up for more than one year, about 63% received chemotherapy.Conclusions: S.N.S.M. and immediate breast reconstruction with silicon implantation for selective case of CA breast is associated with low morbidity and low rate of local recurrence and good aesthetic result with patient satisfaction.

scholarly journals Optimizing Aesthetic Outcomes in Breast Reconstruction After Nipple-Sparing Mastectomy

2020 ◽  
Vol 40 (Supplement_2) ◽  
pp. S13-S21
Author(s):  
Mihye Choi ◽  
Jordan D Frey
Keyword(s):  
Breast Reconstruction ◽  
Preoperative Evaluation ◽  
Management Strategies ◽  
Oncologic Outcomes ◽  
Nipple Areola Complex ◽  
Areola Complex ◽  
Skin Envelope ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Abstract Nipple-sparing mastectomy (NSM) has been associated with improved quality of life and patient satisfaction with similar oncologic outcomes compared with traditional mastectomy techniques. By conserving the nipple-areola complex and the majority of the breast skin envelope, NSM allows for improved aesthetic outcomes after breast reconstruction. However, the technique is also associated with a steep learning curve that must be considered to achieve optimal outcomes. It is important that the plastic surgeon functions in concert with the extirpative breast surgeon to optimize outcomes because the reconstruction is ultimately dependent on the quality of the overlying mastectomy flaps. Various other factors influence the complex interplay between aesthetic and reconstructive outcomes in NSM, including preoperative evaluation, specific implant- and autologous-based considerations, as well as techniques to optimize and correct nipple-areola complex position. Management strategies for complications necessary to salvage a successful reconstruction are also reviewed. Lastly, techniques to expand indications for NSM and maximize nipple viability as well as preshape the breast are discussed. Through thoughtful preoperative planning and intraoperative technique, ideal aesthetic results in NSM may be achieved.

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