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

Alessio Metere,Maria Teresa Lonardo,Domenico Giannotti,Elisabetta Fabiani,Laura Giacomelli,Daniela Pace

doi:10.3390/medicina56040166

Alessio Metere, Maria Teresa Lonardo + Show 4 more

Open Access

https://doi.org/10.3390/medicina56040166

Copy DOI

Abstract

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.

Highlights

Breast cancer was the third most common incident cancer overall with an estimated 2.0 million (95% UI, 1.9–2.0 million) incident cases in 2017
We analyzed the recurrence of the breast cancer in the area where the cancer was originally diagnosed; in the lymph nodes in the armpit or collarbone area near where the cancer was originally diagnosed and another part of the body such as the lungs, bones or brain
215 (24%) patients underwent neoadjuvant therapy, 264 (29.5%) patient performed adjuvant therapy and while the radiotherapy was performed in 87 patients underwent lymph node dissection and resulted positive for macrometastases after lymph node dissection (Table 1)

Summary

Introduction

Breast cancer was the third most common incident cancer overall with an estimated 2.0 million (95% UI, 1.9–2.0 million) incident cases in 2017. It caused 601,000 (95% UI, 579,000–630,000) deaths in women and 11,000 (95% UI, 10,000–11,000) deaths in men, making it the fifth leading cause of cancer deaths for both sexes combined in 2017 globally and the first for women [1]. The choice between medical or surgical treatment depends on the stage of the cancer; in most initial cases conservative treatment is allowed. The present study is a retrospective analysis aimed to evaluate the long-term outcomes of a conservative technique like the nipple-sparing mastectomy. Results: The complications detected were considered as “early” within 1 month later the nipple-sparing mastectomy or “late”

Methods

Results

Discussion

Conclusion