Antônio Luiz Frasson1,2, Martina Lichtenfels3, Alessandra Anton Borba de Souza3, Betina Vollbrecht3, Ana Beatriz Falcone4, Mônica Adriana Rodriguez Martinez Frasson3,4, Fernanda Barbosa4. 1. Breast Cancer Center, Hospital São Lucas, Pontifical Catholic University of Rio Grande Do Sul (PUCRS), Ipiranga 6690, Porto Alegre, Brazil. alfrasson.af@gmail.com. 2. Breast Cancer Group, Albert Einstein Hospital, Albert Einstein avenue 627, São Paulo, Brazil. alfrasson.af@gmail.com. 3. Breast Cancer Center, Hospital São Lucas, Pontifical Catholic University of Rio Grande Do Sul (PUCRS), Ipiranga 6690, Porto Alegre, Brazil. 4. Breast Cancer Group, Albert Einstein Hospital, Albert Einstein avenue 627, São Paulo, Brazil.
Abstract
PURPOSE: 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 oncological safety of nipple-areola complex preservation. In this study, we aimed to evaluate the indications, complication rates, and unfavorable events of 62 Brazilian patients that underwent risk-reducing NSM from 2004 to 2018. METHODS: Patient data were 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 had 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 oncological outcomes and low complication rates in a case series of Brazilian patients.
PURPOSE: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 oncological safety of nipple-areola complex preservation. In this study, we aimed to evaluate the indications, complication rates, and unfavorable events of 62 Brazilian patients that underwent risk-reducing NSM from 2004 to 2018. METHODS:Patient data were 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 had 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 oncological outcomes and low complication rates in a case series of Brazilian patients.
Entities:
Keywords:
Breast neoplasm; Genetic predisposition to disease; Prophylactic surgical procedures; Subcutaneous mastectomy
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