Comparison of oncological safety between nipple sparing mastectomy and total mastectomy using propensity score matching

Abstract

INTRODCUTION Although nipple sparing mastectomy (NSM) has attracted increased recognition as an alternative to traditional mastectomy approaches, its oncological safety is unclear. The purpose of this study was to compare the local recurrence rate between NSM and total mastectomy (TM). METHODS Between 2003 and 2013, 121 and 557 patients with stage 0-III breast cancer underwent NSM and TM respectively. Multivariate Cox regression and propensity score models were used to compare the two groups. RESULTS There was no significant difference in the five-year local recurrence rate between the NSM and TM groups (7.6% vs 4.9%, p=0.398). In multivariate analysis, NSM was not a risk factor for local recurrence (hazard ratio: 1.653, 95% confidence interval: 0.586-4.663, p=0.343). Propensity score matching found similar five-year local recurrence free survival rates between the two groups (92.3% vs 93.7%, p=0.655). CONCLUSIONS Our results suggest that NSM may provide oncological safety comparable with mastectomy for carefully selected patients.

Oncological safety of nipple-sparing mastectomy in young patients with breast cancer compared with conventional mastectomy

“…The mean follow-up time was 38 months (range, 7.4–156 months) and the overall LR rate was 2.38%. In recent years, studies have indicated that NSM was safe for oncology and led to similar LR and OS rates compared with those of patients treated with CM ( 18 , 34 ). These results were similar to those of the present study.…”

“…Numerous previous prospective and retrospective studies, comprising patients with varying sample sizes, inclusion criteria and follow-up durations, have reported an LR rate of 0–24% following NSM ( 12 , 16 – 18 , 32 – 34 ). Although Benediktsson and Perbeck ( 33 ) reported a highest LR rate of 24% among these studies, the NAC recurrence rate was 4%.…”

Stacked Microsurgical Autologous Flap Breast Reconstruction Is an Ideal Option after Unilateral Nipple-Sparing Mastectomy

“…[1][2][3][4][5][6][7][8][9][10][11][12] Autologous reconstruction in NSM is a safe and effective option that achieves an aesthetic, natural-appearing breast in a single stage. 14,15 However, patients undergoing NSM may be more likely to have a low BMI with a paucity of adequate donor site tissue for reconstruction.…”

“…Recent studies suggest similar recurrence rates with NSM compared with traditional mastectomy techniques. [1][2][3][4][5][6] Moreover, NSM has been demonstrated in multiple studies to be a safe and effective procedure from a reconstructive perspective, with acceptably low rates of NAC necrosis among other complications. [7][8][9][10][11][12] As the indications for NSM continue to be established, the popularity of this procedure has risen among both patients and surgeons.…”

Oncologic outcomes after nipple‐sparing mastectomy: A single‐institution experience

“…Nipple-sparing mastectomy (NSM) is the latest advancement in the treatment of breast cancer [1][2][3][4][5]. While increasing in popularity [6,7], NSM remains controversial due to concern for occult tumor cells in the nipple-areola complex.…”