Nipple sparing mastectomy: Surgical and oncological outcomes from a national multicentric registry with 913 patients (1006 cases) over a six year period

Lorenzo Orzalesi, Donato Casella, Caterina Santi, Lorenzo Cecconi, Roberto Murgo, Stefano Rinaldi, Lea Regolo, Claudio Amanti, Manuela Roncella, Margherita Serra, Graziano Meneghini, Massimiliano Bortolini, Vittorio Altomare, Carlo Cabula, Francesca Catalano, Alfredo Cirilli, Francesco Caruso, Maria Grazia Lazzaretti, Luigi Cataliotti, Marco Bernini

Research output: Contribution to journalArticle

35 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)75-81
Number of pages7
JournalBreast
Volume25
DOIs
Publication statusPublished - Feb 1 2016

Fingerprint

Nipples
Mastectomy
Registries
Recurrence
Necrosis
Italy
Appointments and Schedules
Databases
Guidelines
Skin
Neoplasms
Prophylactic Mastectomy

Keywords

  • Locoregional breast recurrences
  • National registry
  • Nipple areola complex necrosis
  • Nipple areola complex recurrences
  • Nipple sparing mastectomy

ASJC Scopus subject areas

  • Surgery

Cite this

Nipple sparing mastectomy : Surgical and oncological outcomes from a national multicentric registry with 913 patients (1006 cases) over a six year period. / Orzalesi, Lorenzo; Casella, Donato; Santi, Caterina; Cecconi, Lorenzo; Murgo, Roberto; Rinaldi, Stefano; Regolo, Lea; Amanti, Claudio; Roncella, Manuela; Serra, Margherita; Meneghini, Graziano; Bortolini, Massimiliano; Altomare, Vittorio; Cabula, Carlo; Catalano, Francesca; Cirilli, Alfredo; Caruso, Francesco; Lazzaretti, Maria Grazia; Cataliotti, Luigi; Bernini, Marco.

In: Breast, Vol. 25, 01.02.2016, p. 75-81.

Research output: Contribution to journalArticle

Orzalesi, L, Casella, D, Santi, C, Cecconi, L, Murgo, R, Rinaldi, S, Regolo, L, Amanti, C, Roncella, M, Serra, M, Meneghini, G, Bortolini, M, Altomare, V, Cabula, C, Catalano, F, Cirilli, A, Caruso, F, Lazzaretti, MG, Cataliotti, L & Bernini, M 2016, 'Nipple sparing mastectomy: Surgical and oncological outcomes from a national multicentric registry with 913 patients (1006 cases) over a six year period', Breast, vol. 25, pp. 75-81. https://doi.org/10.1016/j.breast.2015.10.010
Orzalesi, Lorenzo ; Casella, Donato ; Santi, Caterina ; Cecconi, Lorenzo ; Murgo, Roberto ; Rinaldi, Stefano ; Regolo, Lea ; Amanti, Claudio ; Roncella, Manuela ; Serra, Margherita ; Meneghini, Graziano ; Bortolini, Massimiliano ; Altomare, Vittorio ; Cabula, Carlo ; Catalano, Francesca ; Cirilli, Alfredo ; Caruso, Francesco ; Lazzaretti, Maria Grazia ; Cataliotti, Luigi ; Bernini, Marco. / Nipple sparing mastectomy : Surgical and oncological outcomes from a national multicentric registry with 913 patients (1006 cases) over a six year period. In: Breast. 2016 ; Vol. 25. pp. 75-81.
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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.",
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AU - Orzalesi, Lorenzo

AU - Casella, Donato

AU - Santi, Caterina

AU - Cecconi, Lorenzo

AU - Murgo, Roberto

AU - Rinaldi, Stefano

AU - Regolo, Lea

AU - Amanti, Claudio

AU - Roncella, Manuela

AU - Serra, Margherita

AU - Meneghini, Graziano

AU - Bortolini, Massimiliano

AU - Altomare, Vittorio

AU - Cabula, Carlo

AU - Catalano, Francesca

AU - Cirilli, Alfredo

AU - Caruso, Francesco

AU - Lazzaretti, Maria Grazia

AU - Cataliotti, Luigi

AU - Bernini, Marco

PY - 2016/2/1

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N2 - 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.

AB - 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.

KW - Locoregional breast recurrences

KW - National registry

KW - Nipple areola complex necrosis

KW - Nipple areola complex recurrences

KW - Nipple sparing mastectomy

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