Oncological Outcomes of Nipple-Sparing Mastectomy: A Single-Center Experience of 1989 Patients

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Abstract

Background: Nipple-sparing mastectomy (NSM) is increasingly used in women with breast cancer who are not eligible for conservative surgery, but extensive outcome data are lacking and indications have not been established. Objective: The aim of this study was to assess the oncological outcomes of NSM in a large series of patients with invasive or in situ breast cancer treated at a single center. Methods: We analyzed 1989 consecutive women who had an NSM in 2003–2011, for invasive (1711 patients) or in situ cancer (278 patients) at the European Institute of Oncology, Italy, and followed-up to December 2016. Endpoints were local recurrences, recurrences in the nipple-areola complex (NAC), NAC necrosis, and overall survival (OS). Results: After a median follow-up of 94 months (interquartile range 70–117), 91/1711 (5.3%) patients with invasive cancer had local recurrence (4.8% invasive disease, 0.5% in situ disease), and 11/278 (4.0%) patients with in situ disease had local recurrence (1.8% invasive disease, 2.2% in situ disease). Thirty-six (1.8%) patients had NAC recurrence, 9 with in situ disease (4 invasive and 5 in situ recurrences), and 27 with invasive disease (18 invasive and 9 in situ recurrences). NAC loss for necrosis occurred in 66 (3.3%) patients. There were 131 (6.6%) deaths, 109 (5.5%) as a result of breast cancer. OS at 5 years was 96.1% in women with invasive cancer and 99.2% in women with in situ disease. Conclusions: The findings in this large series, with a median follow-up of nearly 8 years, indicate that NSM is oncologically safe for selected patients. The rate of NAC loss was acceptably low.

Original languageEnglish
Pages (from-to)3849-3857
Number of pages9
JournalAnnals of Surgical Oncology
Volume25
Issue number13
DOIs
Publication statusPublished - Dec 1 2018

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Nipples
Mastectomy
Recurrence
Breast Neoplasms
Necrosis
Neoplasms
Survival
Italy

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

@article{1109e916789d47e49b62341314c3873f,
title = "Oncological Outcomes of Nipple-Sparing Mastectomy: A Single-Center Experience of 1989 Patients",
abstract = "Background: Nipple-sparing mastectomy (NSM) is increasingly used in women with breast cancer who are not eligible for conservative surgery, but extensive outcome data are lacking and indications have not been established. Objective: The aim of this study was to assess the oncological outcomes of NSM in a large series of patients with invasive or in situ breast cancer treated at a single center. Methods: We analyzed 1989 consecutive women who had an NSM in 2003–2011, for invasive (1711 patients) or in situ cancer (278 patients) at the European Institute of Oncology, Italy, and followed-up to December 2016. Endpoints were local recurrences, recurrences in the nipple-areola complex (NAC), NAC necrosis, and overall survival (OS). Results: After a median follow-up of 94 months (interquartile range 70–117), 91/1711 (5.3{\%}) patients with invasive cancer had local recurrence (4.8{\%} invasive disease, 0.5{\%} in situ disease), and 11/278 (4.0{\%}) patients with in situ disease had local recurrence (1.8{\%} invasive disease, 2.2{\%} in situ disease). Thirty-six (1.8{\%}) patients had NAC recurrence, 9 with in situ disease (4 invasive and 5 in situ recurrences), and 27 with invasive disease (18 invasive and 9 in situ recurrences). NAC loss for necrosis occurred in 66 (3.3{\%}) patients. There were 131 (6.6{\%}) deaths, 109 (5.5{\%}) as a result of breast cancer. OS at 5 years was 96.1{\%} in women with invasive cancer and 99.2{\%} in women with in situ disease. Conclusions: The findings in this large series, with a median follow-up of nearly 8 years, indicate that NSM is oncologically safe for selected patients. The rate of NAC loss was acceptably low.",
author = "Viviana Galimberti and Consuelo Morigi and Vincenzo Bagnardi and Giovanni Corso and Elisa Vicini and Fontana, {Sabrina Kahler Ribeiro} and Paola Naninato and Silvia Ratini and Francesca Magnoni and Antonio Toesca and Andriana Kouloura and Mario Rietjens and {De Lorenzi}, Francesca and Andrea Vingiani and Paolo Veronesi",
year = "2018",
month = "12",
day = "1",
doi = "10.1245/s10434-018-6759-0",
language = "English",
volume = "25",
pages = "3849--3857",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York LLC",
number = "13",

}

TY - JOUR

T1 - Oncological Outcomes of Nipple-Sparing Mastectomy

T2 - A Single-Center Experience of 1989 Patients

AU - Galimberti, Viviana

AU - Morigi, Consuelo

AU - Bagnardi, Vincenzo

AU - Corso, Giovanni

AU - Vicini, Elisa

AU - Fontana, Sabrina Kahler Ribeiro

AU - Naninato, Paola

AU - Ratini, Silvia

AU - Magnoni, Francesca

AU - Toesca, Antonio

AU - Kouloura, Andriana

AU - Rietjens, Mario

AU - De Lorenzi, Francesca

AU - Vingiani, Andrea

AU - Veronesi, Paolo

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Background: Nipple-sparing mastectomy (NSM) is increasingly used in women with breast cancer who are not eligible for conservative surgery, but extensive outcome data are lacking and indications have not been established. Objective: The aim of this study was to assess the oncological outcomes of NSM in a large series of patients with invasive or in situ breast cancer treated at a single center. Methods: We analyzed 1989 consecutive women who had an NSM in 2003–2011, for invasive (1711 patients) or in situ cancer (278 patients) at the European Institute of Oncology, Italy, and followed-up to December 2016. Endpoints were local recurrences, recurrences in the nipple-areola complex (NAC), NAC necrosis, and overall survival (OS). Results: After a median follow-up of 94 months (interquartile range 70–117), 91/1711 (5.3%) patients with invasive cancer had local recurrence (4.8% invasive disease, 0.5% in situ disease), and 11/278 (4.0%) patients with in situ disease had local recurrence (1.8% invasive disease, 2.2% in situ disease). Thirty-six (1.8%) patients had NAC recurrence, 9 with in situ disease (4 invasive and 5 in situ recurrences), and 27 with invasive disease (18 invasive and 9 in situ recurrences). NAC loss for necrosis occurred in 66 (3.3%) patients. There were 131 (6.6%) deaths, 109 (5.5%) as a result of breast cancer. OS at 5 years was 96.1% in women with invasive cancer and 99.2% in women with in situ disease. Conclusions: The findings in this large series, with a median follow-up of nearly 8 years, indicate that NSM is oncologically safe for selected patients. The rate of NAC loss was acceptably low.

AB - Background: Nipple-sparing mastectomy (NSM) is increasingly used in women with breast cancer who are not eligible for conservative surgery, but extensive outcome data are lacking and indications have not been established. Objective: The aim of this study was to assess the oncological outcomes of NSM in a large series of patients with invasive or in situ breast cancer treated at a single center. Methods: We analyzed 1989 consecutive women who had an NSM in 2003–2011, for invasive (1711 patients) or in situ cancer (278 patients) at the European Institute of Oncology, Italy, and followed-up to December 2016. Endpoints were local recurrences, recurrences in the nipple-areola complex (NAC), NAC necrosis, and overall survival (OS). Results: After a median follow-up of 94 months (interquartile range 70–117), 91/1711 (5.3%) patients with invasive cancer had local recurrence (4.8% invasive disease, 0.5% in situ disease), and 11/278 (4.0%) patients with in situ disease had local recurrence (1.8% invasive disease, 2.2% in situ disease). Thirty-six (1.8%) patients had NAC recurrence, 9 with in situ disease (4 invasive and 5 in situ recurrences), and 27 with invasive disease (18 invasive and 9 in situ recurrences). NAC loss for necrosis occurred in 66 (3.3%) patients. There were 131 (6.6%) deaths, 109 (5.5%) as a result of breast cancer. OS at 5 years was 96.1% in women with invasive cancer and 99.2% in women with in situ disease. Conclusions: The findings in this large series, with a median follow-up of nearly 8 years, indicate that NSM is oncologically safe for selected patients. The rate of NAC loss was acceptably low.

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U2 - 10.1245/s10434-018-6759-0

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JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

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