Risk-reducing adenomastectomy: series of 124 procedures carried out in brazilian patients

Abstract

Objective: Women with mutations in breast cancer predisposition genes have a significantly higher lifetime risk of developing breast cancer and can opt for risk-reducing mastectomy. Women with positive family history of cancer can also opt for prophylactic surgery as a preventive method in selected cases. Current studies showed reduced risk of developing breast cancer after prophylactic nipple-sparing mastectomy; however, despite the good clinical outcomes, one of the main concerns regarding nipple-sparing mastectomy (NSM) is the oncologic safety and nipple-areola complex preservation. In this study, we aimed to evaluate the indications, complication rates and unfavorable events of 62 Brazilian patients who underwent 124 risk-reducing NSM from 2004 to 2018. Methods: Patient data was reviewed retrospectively and descriptive statistics were utilized to summarize the findings. Results: The mean patients’ age was 43.8 years. The main indication for risk-reducing NSM was the presence of pathogenic mutation (53.3%), followed by atypia or lobular carcinoma in situ (25.8), and family history of breast cancer and/or ovarian cancer (20.9%). There were four (3.2%) incidental diagnosis of ductal carcinoma in situ and one invasive ductal carcinoma (0.8%). From the 124 prophylactic NSM performed, two (1.6%) complications occurred: one (0.8%) infection and one (0.8%) partial nipple necrosis. In a mean follow-up of 50 months, there was one (1.6%) newly diagnosed breast cancer in the 62 patients undergoing prophylactic NSM. Conclusions Our findings demonstrated efficacy and safety to perform NSM as prophylactic surgery with good oncologic outcomes and low complication rates in a case series of Brazilian patients.