Abstract
Nipple-sparing mastectomy with immediate breast reconstruction – early complications and outcomes of the treatment
- Department of Surgical Oncology, Holycross Cancer Centre, Kielce, Poland
- Institute of the Health Sciences, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Department of Radiotherapy, Holycross Cancer Centre, Kielce, Poland
- Department of Surgical Oncology with Sub-unit for the Treatment of Breast Diseases, The Holy Virgin Mary Provincial Specialist Hospital, Częstochowa, Poland
- Department of Surgical Oncology, Janusz Korczak Provincial Specialist Hospital, Słupsk, Poland
- Department of Head and Neck Cancer Surgery, Breast Cancer Unit, Medical University of Łódź, Poland
Introduction
To assess the early complications and outcomes of the treatment of patients undergoing nipple-sparing mastectomy (NSM) with immediate breast reconstruction.
Material and methods
A retrospective study was performed on 120 patients who underwent 130 NSM (10 bilateral) procedures between 1.01.2015 and 31.12.2017 in two oncology centers in Poland. In 80 patients a breast cancer was recognized. Sixteen patients underwent operations on the basis of being carriers of the BRCA1 mutation. The follow-up period ranged from 10 to 34 months. The NSM procedures were performed with or without skin reduction and a free nipple-areola complex (NAC) transplant, with 130 prosthetic devices inserted subpectorally. Breast cancer patients followed the standard protocol for adjuvant therapy.
Results
The patients for risk-reducing mastectomies were younger. Prevalent histology was no special type (NST) in 60 out of 80 patients, mean tumor – NAC distance was 43.3 mm. The prevalent biological subtype was Luminal B HER2-negative. Adjuvant management consisted of chemotherapy in 61 and radiotherapy in 35 patients. We noted 14 cases of complications, 13 in the cancer group, and 1 in the non-cancer group. Skin necrosis was the most common. The mean time for the appearance of the complications was 2.8 months. No local recurrences were observed
Conclusions
NSM is a safe and effective surgical option for qualified patients with breast cancer and in risk-reducing mastectomies.
Keywords
breast cancer, BRCA1, subcutaneous mastectomy, immediate breast reconstruction
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