Overall Survival, Disease-Free Survival, Local Recurrence, and Nipple–Areolar Recurrence in the Setting of Nipple-Sparing Mastectomy: A Meta-Analysis and Systematic Review

Abstract

This study did not detect adverse oncologic outcomes of NSM in carefully selected women with early-stage breast cancer. Use of prospective data registries, notably the Nipple-Sparing Mastectomy Registry, will add clarity to this important clinical question.

Nipple-sparing mastectomies: Clinical outcomes from a single academic institution

“…Over the years, a number of prospective and retrospective studies have demonstrated a cancer recurrence rate in the NAC of up to 2%, with local recurrence rates ranging from 1-6% (17)(18)(19). A more recent meta-analysis comparing NSM to skin-sparing mastectomy (SSM) and/or modified radical mastectomy (MRM) identified no difference in overall survival, disease free survival or local recurrence amongst the groups in properly selected patients with early stage breast cancer (20).…”

Can Vascular Patterns on Preoperative Magnetic Resonance Imaging Help Predict Skin Necrosis after Nipple-Sparing Mastectomy?

“…Nipple-sparing mastectomy (NSM), which has emerged as an alternative to standard mastectomy, is felt to be oncologically safe, provides cosmetic and quality-of-life benefits for patients, and results in a reduced need for additional nipple reconstruction procedures (3)(4)(5)(6)(7)(8)(9)(10)(11)(12). However, one of the frequent complications following NSM is nipple-areola complex (NAC) and skin flap ischemia and necrosis, the rate of which varies from 0 to 48%, with most series reporting rates of 10-15% (1, 3, 4, 6-9, 11, 13-25).…”

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.…”