TY - JOUR
T1 - Conservative mastectomy versus nipple-sparing mastectomy
T2 - Preliminary considerations of oncological safety on 30 patients not receiving intra-operative radiotherapy
AU - Brambullo, Tito
AU - Venezia, Erica Dalla
AU - Martella, Stefano
AU - Vindigni, Vincenzo
AU - Bassetto, Franco
AU - Gottardi, Alessandra
AU - Lohsiriwat, Visnu
AU - Petit, Jean Yves
AU - Veronesi, Paolo
AU - Rietjens, Mario
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Background: For several years, there has been broad consensus that nipple-sparing mastectomy is a safe surgical treatment for breast cancer. However, the technique is associated with a relatively high risk of local recurrence (LR) behind the nipple-areola complex (NAC). It is for this reason that some years ago we introduced intraoperative radiotherapy with electrons (ELIOT) targeted specifically to the NAC to reduce the probability of recurrence there. However, in some cases we preferred to avoid ELIOT when the NAC appears to have a poor blood supply to ensuring the best chance of NAC survival. Methods: From July 2003 to April 2010 at our institute, 30 patients received nipple-sparing mastectomy but neither ELIOT nor external radiotherapy, as the surgeon considered the irradiation would markedly compromise the chances of NAC survival, because of sub-optimal vascularization. Results: After a median follow-up of 5 years there were no LRs with minor post-operative complications. Conclusions: This preliminary case series indicates that the presented technique can be a safe procedure in breast cancer surgery, but requires greater number of cases and a longer follow-up to confirm the oncological safety.
AB - Background: For several years, there has been broad consensus that nipple-sparing mastectomy is a safe surgical treatment for breast cancer. However, the technique is associated with a relatively high risk of local recurrence (LR) behind the nipple-areola complex (NAC). It is for this reason that some years ago we introduced intraoperative radiotherapy with electrons (ELIOT) targeted specifically to the NAC to reduce the probability of recurrence there. However, in some cases we preferred to avoid ELIOT when the NAC appears to have a poor blood supply to ensuring the best chance of NAC survival. Methods: From July 2003 to April 2010 at our institute, 30 patients received nipple-sparing mastectomy but neither ELIOT nor external radiotherapy, as the surgeon considered the irradiation would markedly compromise the chances of NAC survival, because of sub-optimal vascularization. Results: After a median follow-up of 5 years there were no LRs with minor post-operative complications. Conclusions: This preliminary case series indicates that the presented technique can be a safe procedure in breast cancer surgery, but requires greater number of cases and a longer follow-up to confirm the oncological safety.
KW - Breast cancer
KW - Conservative mastectomy
KW - Intraoperative radiotherapy with electrons (ELIOT)
KW - Nipple-sparing mastectomy
KW - Radiotherapy
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U2 - 10.21037/gs.2017.07.17
DO - 10.21037/gs.2017.07.17
M3 - Article
AN - SCOPUS:85037843209
VL - 6
SP - 654
EP - 658
JO - Gland Surgery
JF - Gland Surgery
SN - 2227-684X
IS - 6
ER -