Abstract P2-13-23: The oncologic safety of nipple-areolar complex skin sparing mastectomy compared with skin sparing mastectomy: 8 years follow up results

Abstract

Abstract Background: Skin sparing mastectomy (SSM) has been conducted in breast cancer patient because of both oncologic safety and cosmetic satisfaction. Preservation of nipple-areolar complex (NAC) is helpful to keep more natural breast shape, but, can cause anxiety about local recurrence. This study reviewed long term follow-up result of SSM and nipple-areolar skin sparing mastectomy (NASSM), retrospectively. Patients and methods: This study included 272 primary breast cancer patients who received SSM (94 patients) or NASSM (178 patients) except bilateral breast cancer from September 1996 to December 2008. Frozen section was conducted for analysis of NAC resection margin status. In case of positive resection margin, NAC was sacrificed. Local recurrence and overall survival of SSM and NASSM group was analyzed. Results: The mean follow-up was 94.9 months. 81 NAC resection margins (29.8%) were invaded by tumor cells. The positive resection margin of NAC was associated with presence of ductal carcinoma in situ (p=0.005), especially extensive intraductal component (p=0.005) and invasive carcinoma with multiplicity (p=0.048). The patients in NASSM group tended to have more worse disease free survival than those in SSM group (75.3% vs 86.2%, P=0.087). But, in analysis of only local recurrence including NAC, there were 25 cases (14.0%, 7 in skin flap and 18 in NAC) of local recurrence in NASSM group and 8 (8.5%) in SSM group. Local recurrence free survival of the NASSM group was 86.0% and that of the SSM group was 91.5% (P=0.278). Distant recurrence after surgical treatment for local relapse occurred in only one SSM case. There was no significant difference for the overall survival between NASSM and SSM group (97.8% vs 96.8%, p=0.556). Conclusion: In this study, result of long term follow up showed that patients in NASSM group tend to have more local recurrence than patients in SSM group, even if there is no statistically significance. However, surgically well-controlled local recurrence of skin flap and/or NAC did not affect on overall survival. NASSM is alternative method for SSM with oncological safety and better cosmetic outcome. Citation Format: Kyung Jun Yeu, Jeong Yeong Park, Jung Eun Choi, Su Hwan Kang, Young Kyung Bae, Soo Jung Lee. The oncologic safety of nipple-areolar complex skin sparing mastectomy compared with skin sparing mastectomy: 8 years follow up results [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-13-23.