Nipple-areola complex sparing mastectomy with periareolar pexy for breast cancer patients with moderately ptotic breasts

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Abstract

Background: Nipple-areola complex sparing mastectomy (NSM) with immediate implant reconstruction has been recently introduced for breast cancer patients who are not candidates for breast preserving surgery. As the cosmetic results in moderately ptotic breasts may not be optimal, a modified NSM with a periareolar pexy (PP-NSM) was introduced at our Institution. Patients selection criteria and complication rates of PP-NSM were prospectively recorded and compared with those of the classical NSM. Results: Over a period of 11 months, 22 PP-NSMs and 35 NSMs were performed. The mean jugular-nipple distance was significantly longer in the PP-NSM as compared with the NSM (22.6 vs. 19.6 cm; p = 0.000), whereas the mean inframammary fold-areola distance was superimposable (5.4 cm). The periareolar mastopexy led to a mean cranial transposition of the nipple-areola complex (NAC) of 2.2 cm (range 1.5-4 cm). Mean breast weight was significantly higher in the PP-NSM as compared with the NSM cohort (336 vs. 236 g; p = 0.003). The only case of total NAC necrosis occurred in the PP-NSM group. Partial NAC necrosis was slightly more frequent in the PP-NSM than in the NSM group (13.6% vs. 2.9%%; p = n.s.), possibly due to the higher percentage of smokers (41.0% vs. 14.0%; p = 0.05). Early cosmetic results were good to excellent from the surgeon's and the patient's point of view in over 80% of the cases. Conclusions: PP-NSM allows good cosmetic results and low complication rates in patients with moderately ptotic breasts requiring a mastectomy. In particular, PP-NSM seems to be a good option for women at high risk for developing breast cancer and for selected patients affected by non-locally advanced breast cancer.

Original languageEnglish
Pages (from-to)296-303
Number of pages8
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Volume65
Issue number3
DOIs
Publication statusPublished - Mar 2012

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Nipples
Mastectomy
Breast
Breast Neoplasms
Cosmetics

Keywords

  • Breast cancer
  • Breast reconstruction
  • Nipple-areola complex sparing mastectomy
  • Periareolar pexy

ASJC Scopus subject areas

  • Surgery

Cite this

@article{9718e952570e4295bfc3a07ed50ce565,
title = "Nipple-areola complex sparing mastectomy with periareolar pexy for breast cancer patients with moderately ptotic breasts",
abstract = "Background: Nipple-areola complex sparing mastectomy (NSM) with immediate implant reconstruction has been recently introduced for breast cancer patients who are not candidates for breast preserving surgery. As the cosmetic results in moderately ptotic breasts may not be optimal, a modified NSM with a periareolar pexy (PP-NSM) was introduced at our Institution. Patients selection criteria and complication rates of PP-NSM were prospectively recorded and compared with those of the classical NSM. Results: Over a period of 11 months, 22 PP-NSMs and 35 NSMs were performed. The mean jugular-nipple distance was significantly longer in the PP-NSM as compared with the NSM (22.6 vs. 19.6 cm; p = 0.000), whereas the mean inframammary fold-areola distance was superimposable (5.4 cm). The periareolar mastopexy led to a mean cranial transposition of the nipple-areola complex (NAC) of 2.2 cm (range 1.5-4 cm). Mean breast weight was significantly higher in the PP-NSM as compared with the NSM cohort (336 vs. 236 g; p = 0.003). The only case of total NAC necrosis occurred in the PP-NSM group. Partial NAC necrosis was slightly more frequent in the PP-NSM than in the NSM group (13.6{\%} vs. 2.9{\%}{\%}; p = n.s.), possibly due to the higher percentage of smokers (41.0{\%} vs. 14.0{\%}; p = 0.05). Early cosmetic results were good to excellent from the surgeon's and the patient's point of view in over 80{\%} of the cases. Conclusions: PP-NSM allows good cosmetic results and low complication rates in patients with moderately ptotic breasts requiring a mastectomy. In particular, PP-NSM seems to be a good option for women at high risk for developing breast cancer and for selected patients affected by non-locally advanced breast cancer.",
keywords = "Breast cancer, Breast reconstruction, Nipple-areola complex sparing mastectomy, Periareolar pexy",
author = "Alessandro Rivolin and Franziska Kubatzki and Francesco Marocco and Laura Martincich and Stefania Renditore and Furio Maggiorotto and Alessandra Magistris and Riccardo Ponzone",
year = "2012",
month = "3",
doi = "10.1016/j.bjps.2011.09.023",
language = "English",
volume = "65",
pages = "296--303",
journal = "Journal of Plastic, Reconstructive and Aesthetic Surgery",
issn = "1748-6815",
publisher = "Churchill Livingstone",
number = "3",

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T1 - Nipple-areola complex sparing mastectomy with periareolar pexy for breast cancer patients with moderately ptotic breasts

AU - Rivolin, Alessandro

AU - Kubatzki, Franziska

AU - Marocco, Francesco

AU - Martincich, Laura

AU - Renditore, Stefania

AU - Maggiorotto, Furio

AU - Magistris, Alessandra

AU - Ponzone, Riccardo

PY - 2012/3

Y1 - 2012/3

N2 - Background: Nipple-areola complex sparing mastectomy (NSM) with immediate implant reconstruction has been recently introduced for breast cancer patients who are not candidates for breast preserving surgery. As the cosmetic results in moderately ptotic breasts may not be optimal, a modified NSM with a periareolar pexy (PP-NSM) was introduced at our Institution. Patients selection criteria and complication rates of PP-NSM were prospectively recorded and compared with those of the classical NSM. Results: Over a period of 11 months, 22 PP-NSMs and 35 NSMs were performed. The mean jugular-nipple distance was significantly longer in the PP-NSM as compared with the NSM (22.6 vs. 19.6 cm; p = 0.000), whereas the mean inframammary fold-areola distance was superimposable (5.4 cm). The periareolar mastopexy led to a mean cranial transposition of the nipple-areola complex (NAC) of 2.2 cm (range 1.5-4 cm). Mean breast weight was significantly higher in the PP-NSM as compared with the NSM cohort (336 vs. 236 g; p = 0.003). The only case of total NAC necrosis occurred in the PP-NSM group. Partial NAC necrosis was slightly more frequent in the PP-NSM than in the NSM group (13.6% vs. 2.9%%; p = n.s.), possibly due to the higher percentage of smokers (41.0% vs. 14.0%; p = 0.05). Early cosmetic results were good to excellent from the surgeon's and the patient's point of view in over 80% of the cases. Conclusions: PP-NSM allows good cosmetic results and low complication rates in patients with moderately ptotic breasts requiring a mastectomy. In particular, PP-NSM seems to be a good option for women at high risk for developing breast cancer and for selected patients affected by non-locally advanced breast cancer.

AB - Background: Nipple-areola complex sparing mastectomy (NSM) with immediate implant reconstruction has been recently introduced for breast cancer patients who are not candidates for breast preserving surgery. As the cosmetic results in moderately ptotic breasts may not be optimal, a modified NSM with a periareolar pexy (PP-NSM) was introduced at our Institution. Patients selection criteria and complication rates of PP-NSM were prospectively recorded and compared with those of the classical NSM. Results: Over a period of 11 months, 22 PP-NSMs and 35 NSMs were performed. The mean jugular-nipple distance was significantly longer in the PP-NSM as compared with the NSM (22.6 vs. 19.6 cm; p = 0.000), whereas the mean inframammary fold-areola distance was superimposable (5.4 cm). The periareolar mastopexy led to a mean cranial transposition of the nipple-areola complex (NAC) of 2.2 cm (range 1.5-4 cm). Mean breast weight was significantly higher in the PP-NSM as compared with the NSM cohort (336 vs. 236 g; p = 0.003). The only case of total NAC necrosis occurred in the PP-NSM group. Partial NAC necrosis was slightly more frequent in the PP-NSM than in the NSM group (13.6% vs. 2.9%%; p = n.s.), possibly due to the higher percentage of smokers (41.0% vs. 14.0%; p = 0.05). Early cosmetic results were good to excellent from the surgeon's and the patient's point of view in over 80% of the cases. Conclusions: PP-NSM allows good cosmetic results and low complication rates in patients with moderately ptotic breasts requiring a mastectomy. In particular, PP-NSM seems to be a good option for women at high risk for developing breast cancer and for selected patients affected by non-locally advanced breast cancer.

KW - Breast cancer

KW - Breast reconstruction

KW - Nipple-areola complex sparing mastectomy

KW - Periareolar pexy

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