Details

Autor(en) / Beteiligte

• Fortunato, Lucio
• Loreti, Andrea
• Andrich, Renato
• Costarelli, Leopoldo
• Amini, Mostafà
• Farina, Massimo
• Santini, Elena
• Vitelli, Carlo E.

Titel

When mastectomy is needed: Is the nipple-sparing procedure a new standard with very few contraindications?

Ist Teil von

• Journal of surgical oncology, 2013-09, Vol.108 (4), p.207-212

Ort / Verlag

United States: Blackwell Publishing Ltd

Erscheinungsjahr

2013

Quelle

Wiley Online Library - AutoHoldings Journals

Beschreibungen/Notizen

• Background and Objectives Nipple‐sparing mastectomy (NSM) improves cosmetic results after mastectomy. As most consider advanced tumors, or tumors near the nipple–areola complex (NAC), as a contraindication for this type of surgery, we challenged this hypothesis. Methods One hundred thirty‐eight NSM were performed in 121 consecutive patients. In 122 procedures for cancer, patients were included if there was no evidence of NAC proximity (<1 cm), and if the retro‐areolar margin was negative, even for locally advanced tumors or after neoadjuvant chemotherapy. Results Total NAC necrosis occurred in six cases (4.3%). Additionally, NAC was removed after histological exam of the retro‐areolar tissue in 19 cases (16% of cancer patients). Among 93 cases whose tumor‐to‐NAC distance was recorded, NAC was removed in 11/31 cases (35%) if the distance was 1 cm, and in 8/62 cases (12.9%) if it was more than 1 cm (P = 0.01). NAC was removed more frequently in the first half of the study (17/69 vs. 8/69: P = 0.05). At a median follow‐up of 26 months for the cancer patient group, there was only one local recurrence (outside the NAC). Conclusions Our experience adds evidence that NSM is safe, if the retro‐areolar resection margin is clear and maximal surgical clearance is performed. J. Surg. Oncol. 2013 108:207–212. © 2013 Wiley Periodicals, Inc.