scholarly journals Nipple-Sparing Mastectomy Long-Term Outcomes: Early and Late Complications

Medicina ◽  
2020 ◽  
Vol 56 (4) ◽  
pp. 166
Author(s):  
Alessio Metere ◽  
Elisabetta Fabiani ◽  
Maria Teresa Lonardo ◽  
Domenico Giannotti ◽  
Daniela Pace ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Univariate Analysis ◽  
Late Complications ◽  
Breast Cancer Surgery ◽  
Safe Procedure ◽  
Long Term Outcomes ◽  
Areola Complex ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Background and Objectives: The surgical choice treatment of the breast cancer mostly depends on the stage of the disease. In the last years, breast cancer surgery has moved from being destructive to being more respectful of the anatomical and physiological integrity of the gland. The aim of the breast surgery should be finalized to obtain the best aesthetic and functional results, respecting the principles of oncologic radicality. The present study is a retrospective analysis aimed to evaluate the long-term outcomes of a conservative technique like the nipple-sparing mastectomy. Materials and Methods: We observed 894 patients with a median age of 47.5 years old, underwent nipple-sparing mastectomy between 2002–2017. The data acquired include population and tumor characteristics, patient reconstructive outcomes, including locoregional, regional, and distant metastases; other variables, among nipple–areola complex necrosis and infection were collected. Results: The complications detected were considered as “early” within 1 month later the nipple-sparing mastectomy or “late” after this time. The overall complications rate (early and late) and the overall survival and the relapses detected by this study were comparable with those reported in the literature. In order to identify factors that correlate with complications, either early or later, it has been processed an evaluation of the univariate analysis showing adjuvant chemotherapy as the only predictive factor for late complications, while we encountered no predictors for early complications. Conclusions: The present study adds to the data already present in literature, demonstrating that the nipple-sparing mastectomy is a safe procedure, providing good oncological and aesthetic results in patients carefully selected.

Experience with nipple-sparing mastectomy after prior whole-breast radiation.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 173-173
Author(s):  
Aimee Marlena Mackey ◽  
Bret Taback ◽  
Preya Ananthakrishnan ◽  
Sheldon M. Feldman
Keyword(s):  
Breast Cancer ◽  
Brca Mutation ◽  
Breast Cancers ◽  
Ipsilateral Breast ◽  
Immediate Reconstruction ◽  
Areola Complex ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing ◽  
Good Cosmesis

173 Background: Nipple-sparing mastectomy (NSM) is being performed more frequently for risk reduction and breast cancer treatment. Prior whole breast irradiation (WBI) has been considered a contraindication to NSM. This study reviews our NSM experience following prior WBI. Methods: We reviewed our prospective mastectomy database from April 2007 to April 2012 for patients undergoing NSM. Ten patients out of a total 169 NSM were identified that underwent NSM following prior WBI. Data collected included incision type, follow-up, complications, cosmesis, and recurrence. Results: Of the ten NSM patients who received prior WBI, 6 had recurrent ipsilateral breast cancer at the lumpectomy site, 3 developed contralateral breast cancers and opted for bilateral NSM, and 1 patient opted for bilateral NSM after finding a BRCA mutation following BCT. Mean patient age was 53. Two patients had comorbities: 1 hyperlipidemia and 1 former smoker. Three of 10 (30%) developed complications, with 2 partial necrosis of nipple-areola complex (NAC) and 1 complete loss of the NAC (Table). No patient required return to the operating room (local resection in the office was performed for the complete NAC loss) and all patients had good final cosmesis. All patients underwent immediate reconstruction: 5 tissue expanders (TE), 2 DIEP and 3 TRAM flaps. Mean follow up is 23 months with no local recurrences to date. Conclusions: This study demonstrates that NSM with immediate reconstruction can be performed in selected patients with prior WBI with an acceptable rate of nipple preservation and good cosmesis. NAC preservation is the ultimate goal in patients undergoing NSM. Current studies are ongoing to identify risk factors that may be associated with nipple necrosis. [Table: see text]

Occult Nipple Involvement in Breast Cancer: Clinicopathologic Findings in 316 Consecutive Mastectomy Specimens

2009 ◽  
Vol 27 (30) ◽  
pp. 4948-4954 ◽  
Author(s):  
Elena F. Brachtel ◽  
Jennifer E. Rusby ◽  
James S. Michaelson ◽  
L. Leon Chen ◽  
Alona Muzikansky ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Univariate Analysis ◽  
Oncological Safety ◽  
En Face ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

Purpose Although breast-conserving surgery is a standard approach for patients with breast cancer, mastectomy often becomes necessary. Surgical options now include nipple-sparing mastectomy but its oncological safety is still controversial. This study evaluates frequency and patterns of occult nipple involvement in a large contemporary cohort of patients with the retroareolar margin as possible indicator of nipple involvement. Patients and Methods Three hundred sixteen consecutive mastectomy specimens (232 therapeutic, 84 prophylactic) with grossly unremarkable nipples were evaluated by coronal sections through the entire nipple and subareolar tissue. Extent and location of nipple involvement by carcinoma was assessed with the tissue deep to the skin as potential retroareolar en-face resection margin. Results Seventy-one percent of nipples from therapeutic mastectomies showed no pathologic abnormality, 21% had ductal carcinoma in situ (DCIS), invasive carcinoma (IC), or lymphovascular invasion (LVI), and 8% lobular neoplasia (lobular carcinoma in situ). Human epidermal growth factor receptor 2 amplification, tumor size, and tumor-nipple distance were associated with nipple involvement by multivariate analysis (P = .0047, .0126, and .0176); histologic grade of both DCIS (P = .002) and IC (P = .03), LVI (P = .03), and lymph node involvement (P = .02) by univariate analysis. Nipple involvement by IC or DCIS was identified in the retroareolar margin with a sensitivity of 0.8 and a negative predictive value of 0.96. None of the 84 prophylactic mastectomies showed nipple involvement by IC or DCIS. Conclusion Nipple-sparing mastectomy may be suitable for selected cases of breast carcinoma with low probability of nipple involvement by carcinoma and prophylactic procedures. A retroareolar en-face margin may be used to test for occult involvement in patients undergoing nipple-sparing mastectomy.

Breast Cancer: A Review of Risk Factors and New Insights into Treatment

2021 ◽  
Vol 17 ◽  
Author(s):  
Kimia Karami Dolisgan ◽  
Khatereh Anbari
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Cancer Treatment ◽  
Breast Cancer Surgery ◽  
The Common ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing ◽  
Biomedical Investigation ◽  
Surgical Treatments ◽  
Chemotherapy Agents

Abstract: Today, in spite of significant advances in cancer treatment has been made, however, breast cancer is still remains as one of the main health problem and considered as a top biomedical investigation urgency. The present study reviewed the common conventional chemotherapy agents and also some alternative and complementary approaches such as oncolytic virotherapy, bacteriotherapy, nanotherapy, immunotherapy, and natural products which are recommended for breast cancer treatment. In addition to current surgery approaches such as mastectomy, in recent years a number of novel techniques such as robotic mastectomies, nipple-sparing mastectomy, skin-sparing mastectomy, day-case mastectomy were used in breast cancer surgery. In this review, we summarize new insights risk factors, surgical and non-surgical treatments for breast cancer.

Evaluating Long-Term Outcomes following Nipple-Sparing Mastectomy and Reconstruction in the Irradiated Breast

2014 ◽  
Vol 133 (5) ◽  
pp. 605e-614e ◽  
Author(s):  
Scott L. Spear ◽  
John Shuck ◽  
Lindsay Hannan ◽  
Frank Albino ◽  
Ketan M. Patel
Keyword(s):  
Long Term Outcomes ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing

A novel nipple–areola complex involvement predictive index for indicating nipple-sparing mastectomy in breast cancer patients

Breast Cancer ◽  
2019 ◽  
Vol 26 (6) ◽  
pp. 808-816 ◽  
Author(s):  
Hirohito Seki ◽  
Takashi Sakurai ◽  
Shodai Mizuno ◽  
Toshiki Tokuda ◽  
Takuji Kaburagi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Predictive Index ◽  
Nipple Areola Complex ◽  
Areola Complex ◽  
Nipple Sparing Mastectomy ◽  
Nipple Sparing
Sign in / Sign up

Export Citation Format

Share Document