V Mesdag1, C Régis2, E Tresch3, M-P Chauvet1, L Boulanger4, P Collinet5, S Giard1. 1. Department of Surgery, centre Oscar Lambret, 3, rue F.-Combemale, 59020 Lille cedex, France. 2. Department of Surgery, centre Oscar Lambret, 3, rue F.-Combemale, 59020 Lille cedex, France. Electronic address: c-regis@o-lambret.fr. 3. Biostatisitcs Unit, centre Oscar Lambret, 3, rue F.-Combemale, 59020 Lille cedex, France. 4. Department of Surgery, centre Oscar Lambret, 3, rue F.-Combemale, 59020 Lille cedex, France; Department of Gynecologic Surgery, Jeanne de Flandre Hospital, CHU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France. 5. Department of Gynecologic Surgery, Jeanne de Flandre Hospital, CHU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France.
Abstract
BACKGROUND: The preservation of the nipple areolar complex (NAC) for cancer treatment is still a matter of debate because of suspected increase of local recurrence and surgery-specific complications. The aim of the study was to investigate both the relapse risk associated with nipple sparing mastectomy (NSM) for breast cancer and women's satisfaction with preservation of the NAC. METHODS: We included retrospectively all patients who had skin-sparing mastectomy (SSM) or NSM from 2007 to 2012 for breast cancer or ductal carcinoma in situ (DCIS). We compared NSM and SSM group for oncological and surgical outcomes. Patients' satisfaction and quality of life has been evaluated by a specifically designed questionnaire. RESULTS: We included 63NSM (41.5%) and 89SM (58.5%). Eighty-nine (58.6%) patients had DCIS, and the other had small invasive disease. Median follow-up was 42 (IQR: 18-58) months. Local recurrence rate was 1.7% (n=1) in the NSM group and 0% in the SSM group without recurrence in the preserved nipple. After NSM, one patient had complete NAC necrosis, and three patients suffered partial necrosis. Satisfaction with the NAC was higher in the NSM group compared to the SSM group with delayed reconstruction of the nipple (75% vs. 59%, P=0.14). Patients with NSM required less psychological support before (P=0.028) and immediately after surgery (P=0.14) than patients in the SSM group. CONCLUSION: NSM can successfully and safely be performed for pre-invasive and small invasive breast cancer. Besides esthetic aspects, preserving the nipple may ease the acceptance of these radical form of surgery.
BACKGROUND: The preservation of the nipple areolar complex (NAC) for cancer treatment is still a matter of debate because of suspected increase of local recurrence and surgery-specific complications. The aim of the study was to investigate both the relapse risk associated with nipple sparing mastectomy (NSM) for breast cancer and women's satisfaction with preservation of the NAC. METHODS: We included retrospectively all patients who had skin-sparing mastectomy (SSM) or NSM from 2007 to 2012 for breast cancer or ductal carcinoma in situ (DCIS). We compared NSM and SSM group for oncological and surgical outcomes. Patients' satisfaction and quality of life has been evaluated by a specifically designed questionnaire. RESULTS: We included 63NSM (41.5%) and 89SM (58.5%). Eighty-nine (58.6%) patients had DCIS, and the other had small invasive disease. Median follow-up was 42 (IQR: 18-58) months. Local recurrence rate was 1.7% (n=1) in the NSM group and 0% in the SSM group without recurrence in the preserved nipple. After NSM, one patient had complete NACnecrosis, and three patients suffered partial necrosis. Satisfaction with the NAC was higher in the NSM group compared to the SSM group with delayed reconstruction of the nipple (75% vs. 59%, P=0.14). Patients with NSM required less psychological support before (P=0.028) and immediately after surgery (P=0.14) than patients in the SSM group. CONCLUSION: NSM can successfully and safely be performed for pre-invasive and small invasive breast cancer. Besides esthetic aspects, preserving the nipple may ease the acceptance of these radical form of surgery.
Authors: M G Valero; T-A Moo; S Muhsen; E C Zabor; M Stempel; A Pusic; M L Gemignani; M Morrow; V Sacchini Journal: Br J Surg Date: 2020-05-20 Impact factor: 6.939
Authors: Bridget N Kelly; Heather R Faulkner; Barbara L Smith; Jenna E Korotkin; Conor R Lanahan; Carson Brown; Michele A Gadd; Michelle C Specht; Kevin S Hughes; T Salewa Oseni; Amy S Colwell; Suzanne B Coopey Journal: Ann Surg Oncol Date: 2021-09-08 Impact factor: 5.344
Authors: Zoran Radovanovic; Milan Ranisavljevic; Dragana Radovanovic; Ferenc Vicko; Tatjana Ivkovic-Kapicl; Nenad Solajic Journal: Breast Care (Basel) Date: 2018-06-20 Impact factor: 2.860