Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy

Walter P. Weber, Martin Haug, Christian Kurzeder, Vesna Bjelic-Radisic, Rupert Koller, Roland Reitsamer, Florian Fitzal, Jorge Biazus, Fabricio Brenelli, Cicero Urban, Régis Resende Paulinelli, Jens Uwe Blohmer, Jörg Heil, Jürgen Hoffmann, Zoltan Matrai, Giuseppe Catanuto, Viviana Galimberti, Oreste Gentilini, Mitchel Barry, Tal HadarTanir M. Allweis, Oded Olsha, Maria João Cardoso, Pedro F. Gouveia, Isabel T. Rubio, Jana de Boniface, Tor Svensjö, Susanne Bucher, Peter Dubsky, Jian Farhadi, Mathias K. Fehr, Ilario Fulco, Ursula Ganz-Blättler, Andreas Günthert, Yves Harder, Nik Hauser, Elisabeth A. Kappos, Michael Knauer, Julia Landin, Robert Mechera, Francesco Meani, Giacomo Montagna, Mathilde Ritter, Ramon Saccilotto, Fabienne D. Schwab, Daniel Steffens, Christoph Tausch, Jasmin Zeindler, Savas D. Soysal, Visnu Lohsiriwat, Tibor Kovacs, Anne Tansley, Lynda Wyld, Laszlo Romics, Mahmoud El-Tamer, Andrea L. Pusic, Virgilio Sacchini, Michael Gnant

Research output: Contribution to journalReview article

Abstract

Purpose: Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion. Methods: The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology. Results: Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference. Conclusions: In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques.

Original languageEnglish
Pages (from-to)523-537
Number of pages15
JournalBreast Cancer Research and Treatment
Volume172
Issue number3
DOIs
Publication statusPublished - Dec 1 2018

Keywords

  • Breast cancer surgery
  • Immediate breast reconstruction
  • Nipple-sparing mastectomy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Weber, W. P., Haug, M., Kurzeder, C., Bjelic-Radisic, V., Koller, R., Reitsamer, R., Fitzal, F., Biazus, J., Brenelli, F., Urban, C., Paulinelli, R. R., Blohmer, J. U., Heil, J., Hoffmann, J., Matrai, Z., Catanuto, G., Galimberti, V., Gentilini, O., Barry, M., ... Gnant, M. (2018). Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy. Breast Cancer Research and Treatment, 172(3), 523-537. https://doi.org/10.1007/s10549-018-4937-1