Abstract
Nipple-areolar complex (NAC)-related complications are common during nipple-sparing mastectomy (NSM), with obesity as a risk factor. Although the incidence of NAC-related complications after robotic NSM (RNSM) with immediate breast reconstruction (IBR) is lower than that after conventional NSM, it remains one of the most unwanted complications. We aimed to evaluate body composition-based risk factors for NAC-related complications after RNSM with IBR. Data of 92 patients with breast cancer who underwent RNSM with IBR using direct-to-implant or tissue expander from November 2017 to September 2020 were analyzed retrospectively. Risk factors for NAC-related complications were identified with a focus on body composition using preoperative transverse computed tomography at the third lumbar vertebra level. Postoperative complications were assessed for 6 months. The most common complication was NAC ischemia, occurring in 15 patients (16%). Multivariate analysis revealed a low skeletal muscle index/total adipose tissue index (SMI/TATI) ratio as an independent NAC ischemia risk factor. An increase in the SMI/TATI ratio by one decreased the incidence of NAC ischemia by 0.940-fold (p = 0.030). A low SMI/TATI ratio is a risk factor for postoperative NAC ischemia in patients undergoing RNSM with IBR for breast cancer. Preoperative body composition-focused evaluation is more valuable than simple body mass index assessment.
Highlights
Nipple-areolar complex (NAC) ischemia and necrosis are common complications after nipple-sparing mastectomy (NSM) with a prevalence range of 0–48%, mostly 10–15% [1,2,3,4]
The subcutaneous adipose tissue index (SATI), visceral adipose tissue index (VATI), and total adipose tissue index (TATI) were significantly higher (p = 0.007,
NAC ischemia occurred in 16% of patients in the current study, and a low SMI/TATI ratio significantly increased the incidence of NAC ischemia after robotic NSM (RNSM) with immediate breast reconstruction (IBR)
Summary
Nipple-areolar complex (NAC) ischemia and necrosis are common complications after nipple-sparing mastectomy (NSM) with a prevalence range of 0–48%, mostly 10–15% [1,2,3,4]. Several risk factors for NAC-related complications after a mastectomy with breast reconstruction (BR) have been identified, including obesity, ptosis, large breast weight and volume, prior radiotherapy history, and incision type [1,5,6,7,8], among which, obesity is a well-known risk factor [9,10,11]. Obesity is evaluated using body mass index (BMI), which reflects only body height and weight but does not reflect body composition, such as muscle and adipose tissue compositions. A risk factor analysis of current research, especially obesity, with BMI may be limited as it may not account for exact fat and muscle mass. A risk factor analysis of current research, e3s51-
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
