Lorenzo Orzalesi1, Donato Casella2, Caterina Santi3, Lorenzo Cecconi4, Roberto Murgo5, Stefano Rinaldi6, Lea Regolo7, Claudio Amanti8, Manuela Roncella9, Margherita Serra10, Graziano Meneghini11, Massimiliano Bortolini12, Vittorio Altomare13, Carlo Cabula14, Francesca Catalano15, Alfredo Cirilli16, Francesco Caruso17, Maria Grazia Lazzaretti18, Luigi Cataliotti19, Marco Bernini20. 1. Breast Unit Surgery, Oncology Department, Careggi University Hospital, L.go Brambilla 3, 50134 Florence, Italy. Electronic address: lorenzo.orzalesi@unifi.it. 2. Breast Unit Surgery, Oncology Department, Careggi University Hospital, L.go Brambilla 3, 50134 Florence, Italy. Electronic address: donatocasella@gmail.com. 3. Breast Unit Surgery, Oncology Department, Careggi University Hospital, L.go Brambilla 3, 50134 Florence, Italy. Electronic address: caterinasanti12@gmail.com. 4. Statistics, Department of Statistics, Informatics and Application "G.Parenti", University of Florence, Viale Morgagni 59, 50134 Florence, Italy. Electronic address: l.cecconi@disia.unifi.it. 5. Breast Unit Surgery, San Giovanni Rotondo Hospital, Viale Cappuccini 1, 71013 S.Giovanni Rotondo, Foggia, Italy. Electronic address: romurgo@libero.it. 6. Breast Unit Surgery, San Paolo Hospital, Via Capo Scardicchio 92, 70123 Bari, Italy. Electronic address: solostefano@alice.it. 7. Breast Unit Surgery, Maugeri Hospital, Via Maugeri 10, 27100 Pavia, Italy. Electronic address: lea.regolo@fsm.it. 8. Breast Unit Surgery, Sant'Andrea Hospital, Via di Grottarossa 1035, 00189 Rome, Italy. Electronic address: claudio.amanti@uniroma1.it. 9. Breast Unit Surgery, Cisanello Hospital, Via Roma 67, 56123 Pisa, Italy. Electronic address: m.roncella@ao-pisa.toscana.it. 10. Breast Unit Surgery, Sant'Orsola Hospital, Via Massarenti 9, 40138 Bologna, Italy. Electronic address: magserra@hotmail.com. 11. Breast Unit, Montecchio Maggiore Hospital, Via Ca' Rotte 7, 36075 Montecchio Maggiore, Vicenza, Italy. Electronic address: centro.donna@ulss5.it. 12. Breast Unit Surgery, Valdese Hospital, Via Pellico 19, 10125 Turin, Italy. Electronic address: bortolini.m@gmail.com. 13. Breast Unit, Campus Biomedico Hospital, Via Alvaro del Portillo 200, 00128 Rome, Italy. Electronic address: v.altomare@unicampus.it. 14. Breast Unit Surgery, Businco Hospital, Via Jenner 1, 09127 Cagliari, Italy. Electronic address: cabula@tin.it. 15. Breast Unit, Cannizzaro Hospital, Via Messina 829, 95126 Catania, Italy. Electronic address: dr.francescacatalano@virgilio.it. 16. Breast Unit Surgery, Policlinico Hospital, P.zza Giulio Cesare 11, Bari, Italy. Electronic address: cirilli.alfredo@libero.it. 17. Breast Unit Surgery, Humanitas Hospital, Via Vittorio Emanuele da Bormida 64, 95126 Catania, Italy. Electronic address: francesco.caruso@ccocatania.it. 18. Breast Unit Surgery, Ramazzini Hospital, Via Molinari 2, 41012 Carpi (Modena), Italy. Electronic address: m.lazzaretti@ausl.mo.it. 19. President European Breast Centres Certification, President Senonetwork Italia Onlus, Italy. Electronic address: luigi.cataliotti@gmail.com. 20. Breast Unit Surgery, Oncology Department, Careggi University Hospital, L.go Brambilla 3, 50134 Florence, Italy. Electronic address: marco.bern@tin.it.
Abstract
BACKGROUND: Nipple sparing mastectomy is deemed surgically and oncologically safe based on a long lasting literature data from reviews of single institution series. This study aims at evaluating surgical and oncological outcomes of NSM on a large multi-institutional scale, by means of the Italian National registry. METHODS: In July 2011 a panel of Italian specialists agreed upon and designed a National database of NSM. Centers with at least 150 cancers per year and following the National follow-up schedule guidelines could participate inserting any NSM case performed, retrospectively and prospectively from that moment on. In March 2015 analysis of data was accomplished. Dataset for this study consists of cases performed in the period between January 1st 2009 and December 31st 2014. RESULTS: 913 Women were included in the analysis, for a total of 1006 procedures. Prophylactic mastectomies were 124 (12.3%). MRI utilization increased over time. NSM failure rate, with NAC removal for any reason was 11.5%. NAC necrosis rate was 4.8%. Larger skin-flap necrosis rate was 2.3%. Major surgical complications rate was 4.4%. Oncological outcomes were calculated among primitive EBC cases only: locoregional recurrences rate was 2.9%, NAC recurrence 0.7%. Systemic recurrence rate was 1.0%. Five deaths (0.7%) were registered. CONCLUSIONS: More than 10% of NSM procedures are prophylactic mastectomies. MRI is gaining more importance over time. Surgical and oncological results show that NSM is effective. This National multicentric analysis enables a comparison of results with no geographical differences and a "safe" state of the art of NSM in Italy.
BACKGROUND: Nipple sparing mastectomy is deemed surgically and oncologically safe based on a long lasting literature data from reviews of single institution series. This study aims at evaluating surgical and oncological outcomes of NSM on a large multi-institutional scale, by means of the Italian National registry. METHODS: In July 2011 a panel of Italian specialists agreed upon and designed a National database of NSM. Centers with at least 150 cancers per year and following the National follow-up schedule guidelines could participate inserting any NSM case performed, retrospectively and prospectively from that moment on. In March 2015 analysis of data was accomplished. Dataset for this study consists of cases performed in the period between January 1st 2009 and December 31st 2014. RESULTS: 913 Women were included in the analysis, for a total of 1006 procedures. Prophylactic mastectomies were 124 (12.3%). MRI utilization increased over time. NSM failure rate, with NAC removal for any reason was 11.5%. NACnecrosis rate was 4.8%. Larger skin-flap necrosis rate was 2.3%. Major surgical complications rate was 4.4%. Oncological outcomes were calculated among primitive EBC cases only: locoregional recurrences rate was 2.9%, NAC recurrence 0.7%. Systemic recurrence rate was 1.0%. Five deaths (0.7%) were registered. CONCLUSIONS: More than 10% of NSM procedures are prophylactic mastectomies. MRI is gaining more importance over time. Surgical and oncological results show that NSM is effective. This National multicentric analysis enables a comparison of results with no geographical differences and a "safe" state of the art of NSM in Italy.
Authors: Rebeca Neves Heinzen; Alfredo Carlos Simões Dornellas de Barros; Filomena Marino Carvalho; Fernando Nalesso Aguiar; Cristiane da Costa Bandeira Abrahão Nimir; Alfredo Luiz Jacomo Journal: Gland Surg Date: 2020-06
Authors: Monica G Valero; Shirin Muhsen; Tracy-Ann Moo; Emily C Zabor; Michelle Stempel; Andrea Pusic; Mary L Gemignani; Monica Morrow; Virgilio S Sacchini Journal: Ann Surg Oncol Date: 2019-12-10 Impact factor: 5.344
Authors: René Aloisio da Costa Vieira; Luciana Machado Ribeiro; Guilherme Freire Angotti Carrara; Lucas Faria Abrahão-Machado; Ligia Maria Kerr; Afonso Celso Pinto Nazário Journal: Breast Care (Basel) Date: 2019-05-03 Impact factor: 2.860