Nipple-Sparing Mastectomy with Primary Implant Reconstruction: Surgical and Oncological Outcome of 435 Breast Cancer Patients

Radovanović, Zoran; Ranisavljević, Milan; Radovanović, Dragana; Vicko, Ferenc; Ivković-Kapicl, Tatjana; Šolajić, Nenad

doi:10.1159/000489317

Cited by 17 publications

(15 citation statements)

References 45 publications

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“…Many surgeons have tried to develop various incisions in NSM to deliver better cosmetic outcomes (14)(15)(16). Robotassisted nipple-sparing mastectomy (RNSM) is a procedure that uses robotic systems through axillary or lateral incisions, which results in no scars in the overlying skin.…”

Section: Introductionmentioning

confidence: 99%

Post-Operative Complications and Nipple Necrosis Rates Between Conventional and Robotic Nipple-Sparing Mastectomy

et al. 2021

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PurposeThis study is to directly compare surgical outcomes between conventional nipple-sparing mastectomy (CNSM) and robot-assisted nipple-sparing mastectomy (RNSM).Materials and MethodFor this case–control study, 369 cases of 333 patients who underwent CNSM or RNSM with immediate reconstruction between November 2016 and January 2019 at Severance Hospital in Seoul, Republic of Korea were reviewed. Patients with stage IV breast cancer (n = 1), receiving neoadjuvant chemotherapy (n = 43), or subjected to previous operations (n = 14) or radiotherapy on the breasts were excluded. The main outcomes were comparing rates of post-operative complications, of high-grade post-operative complications as defined by the Clavien-Dindo classification, and nipple necrosis between the CNSM and the RNSM groups.ResultsA total of 311 cases, including 270 CNSMs and 41 RNSMs, were analyzed. The rates of post-operative nipple necrosis (p = 0.026, 2.4 vs. 15.2%) and of high-grade post-operative complications (p = 0.031, 34.8 vs. 17.1%) in the RNSM group were significantly lower than those in the CNSM group.ConclusionRNSM was associated with lower rates of high-grade post-operative complications and nipple necrosis than CNSM for patients with small breast volumes and less ptotic breasts.

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Section: Introductionmentioning

confidence: 99%

Post-Operative Complications and Nipple Necrosis Rates Between Conventional and Robotic Nipple-Sparing Mastectomy

et al. 2021

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“…Most common post-surgery complications were hematoma, occurring in 14.7% of patients of a series, capsular contractures, necrosis [19]. Higher local recurrence ranged from 1-7.3%, [18,27]. Other complications registered have been summarized in (Table 2).…”

Section: Resultsmentioning

confidence: 98%

“…From the research performed, 12 articles have been selected for this work, for a total amount of 2859 patients and 3849 NSM, 772 proven procedures of oncologic prophylaxis related to the studies [17][18][19][20][21][22][23][24][25][26][27][28]. The average follow-up varies from 18 to 79 months (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…The most encountered complications in the 12 selected studies were tissue necrosis, followed by infections, although each study reported different percentages (Table 2). Radovanovic analysed early and late post-surgery complications in 64 procedures (14.51%) [18]. 22/26 ischaemic complications received a conservative treatment, and 4 patients requested the surgical removal of the necrotic skin.…”

Section: Most Encountered Complicationsmentioning

confidence: 99%

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Effectiveness of the Nipples-Saving Mastectomy (NSM): Review on the Results, Oncologic Safety and Surgical Complications

Parmeggiani¹,

Mallitti²,

M³

et al. 2020

JSO

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Background: The nipples-saving mastectomy (NSM), most recent technique, allows the whole mammary gland removal preserving the nipple-areola compound (NAC), obtaining oncologic safe results. When indicated, NSM is validated by the great aesthetic results obtained. Objectives: The objective of this review is the evaluation of the effectiveness and oncologic safety of the nipple-saving mastectomy, marking the most frequent complications. Moreover, the possibility to use the NSM procedure as prophylactic mastectomy in patients at high risk has been evaluated. Research Methods: A bibliographic research about clinical studies and previous reviews related to nipplessaving mastectomy has been conducted. No limitation about language was performed. Results: The study included 12 articles, for a total of 2859 patients and 3849 NSM. Patients candidate to NSM, either as a prophylactic or curative treatment of mammary carcinoma, must undergo a careful selection screening. Most frequently occurring surgery-related complications were necrosis and infections; though not altering the cosmetic results, that have been positively evaluated in almost all patients. Conclusion: Preservation of the areola-nipple compound seems to be oncologically safe and does not increase local recurrences, compared to the previous techniques. Moreover, it is associated with better aesthetic results and patients’ higher satisfaction.

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“…Some studies have suggested that NAC was a risk factor for early postoperative complications, but the specific relationship between TTS and complications was still unknown. 5 …”

Section: Introductionmentioning

confidence: 99%

How Long is It Safe to Wait for Breast Surgery After Completion of Neoadjuvant Chemotherapy?

Ma¹,

Mao²,

Wang³

2021

CMAR

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Purpose This study aimed to evaluate the impact of surgical time on postoperative complications and survival outcomes in breast cancer patients after neoadjuvant chemotherapy (NAC). Patients and Methods We retrospectively reviewed breast cancer patients treated at Breast Disease Center of the Affiliated Hospital of Qingdao University, from January 2013 to December 2018. The eligibility criteria were female patients with histologically confirmed primary stage II–III breast cancer and initially treated with NAC, who were <75 years old, and patients for whom medical records were available. The patients with severe comorbidities of other organs, with previous histories of other malignancies or breast cancer, and with distant metastasis or contralateral breast cancer, were excluded. Eligible patients were divided into three groups based on time to surgery (TTS): (A) ≤21 days; (B) between 21 and 28 days; and (C) >28 days. We collected medical records and followed up patients. Results Totally 422 patients were enrolled. The median TTS was 26 days. Among these patients, 119 (28.2%) were in Group A, 152 (36.0%) were in Group B, and 151 (35.8%) were in Group C. Eighty-two (19.4%) patients achieved pathologic complete response (pCR). Survival analysis showed that DFS (P=0.012) and OS (P=0.015) were significantly different among three groups. In multivariate analysis, DFS (HR=2.333, P=0.001) and OS (HR=2.783, P=0.030) were significantly worse when TTS >28 days. Postoperative complications occurred in 96 (22.7%) patients. The incidence of total postoperative complications in the three groups was statistically different (P=0.001) and Group A had worse performance. Multivariate analysis showed that age >50 years old (P=0.004) and TTS ≤21 days (P<0.001) were independent parameters for total postoperative complications. Conclusion Postoperative complications and survival outcomes in breast cancer patients seemed to be influenced by TTS after the NAC. The benefits were remarkable in patients undergoing surgery between 21 and 28 days.

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Nipple-Sparing Mastectomy with Primary Implant Reconstruction: Surgical and Oncological Outcome of 435 Breast Cancer Patients

Cited by 17 publications

References 45 publications

Post-Operative Complications and Nipple Necrosis Rates Between Conventional and Robotic Nipple-Sparing Mastectomy

Post-Operative Complications and Nipple Necrosis Rates Between Conventional and Robotic Nipple-Sparing Mastectomy

Effectiveness of the Nipples-Saving Mastectomy (NSM): Review on the Results, Oncologic Safety and Surgical Complications

How Long is It Safe to Wait for Breast Surgery After Completion of Neoadjuvant Chemotherapy?

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