Nipple sparing mastectomy


Nipple-sparing mastectomy allows the nipple and areola to be intact along with the breast skin.

There are many different incisions used to do this.

In all cases, all visible breast tissue is removed.

Candidates for nipple-sparing mastectomy include:

women whose tumor does not involve the nipple or tissue under the areola

women whose tumors are surrounded by a clear margin of cancer-free tissue

women who have not been diagnosed with inflammatory breast cancer or advanced breast cancer with skin involvement

A new study found a low rate of cancer recurrence at the nipple-areola complex (NAC) in patients with breast cancer who underwent nipple-sparing mastectomy.

Characteristics of the tumor were associated with recurrence risk, including histologic grade and the presence of HER2-positive disease.

NSM is characterized by preservation of the entire nipple-areola complex and breast skin envelope despite the removal of the mammary tissue during mastectomy.

4.1% of cancer recurrence at the NAC as the first event after NSM.

The five-year cumulative incidence of NAC recurrence was 3.5%.

In comparison, the five-year cumulative incidence of local recurrence at other locations other than the NAC was 3.4%.

The median time from surgery to recurrence at the NAC was 35 months.

Patients with hormone receptor-negative/HER2-positive tumors had a higher risk of recurrence at the NAC, with a hazard ratio of 3.051.

High histologic grade was also associated with NAC recurrence, with an HR of 2.6, as was the presence of extensive intraductal component, with an HR of 3.3.

The 10-year overall survival rate was 100% among those with NAC recurrence, and 94.5% among those without such a recurrence.

There was no significant difference between those with and without NAC recurrence with regard to distant metastasis-free survival and OS.

Most patients with cancer recurrence at the NAC had a favorable prognosis after receiving appropriate comprehensive treatment.

MRI studies show that 3% of patients have gross residual breast tissue after mastectomy, 13% after skin sparing mastectomy, and more than 50% of patients after nipple sparing mastectomy.

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