Risk of Locoregional Recurrence in Patients With False-Negative Frozen Section or Close Margins of Retroareolar Specimen in Nipple-Sparing Mastectomy

Kneubil, Maximiliano Cassilha; Lohsiriwat, Visnu; Curigliano, Giuseppe; Brollo, Janaína; Botteri, Edoardo; Rotmensz, Nicole; Martella, Stefano; Mastropasqua, Mauro G.; Iera, Marco; Coelho, Marcio Brussius; Intra, Mattia; Orecchia, Roberto; Rey, Piercarlo; Rietjens, Mario; Petit, Jean Yves

doi:10.1245/s10434-012-2514-0

Cited by 53 publications

(30 citation statements)

References 42 publications

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“…[1][2][3][4] However, more recently, many groups have begun offering the approach to patients with larger tumors and no longer require preoperative magnetic resonance imaging (MRI) to document distance from the NAC, but instead just ensure that examination shows no clinical involvement of the NAC. [5][6][7][8] One group of patients now offered TSSM at some centers are those with locally advanced breast cancer, [9][10][11] although outcomes analysis of these patients after TSSM is limited and often grouped within larger studies that include earlier-stage and prophylactic patients.…”

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confidence: 99%

Expanding the Indications for Total Skin-Sparing Mastectomy: Is It Safe for Patients with Locally Advanced Disease?

et al. 2015

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Expanding the Indications for Total Skin-Sparing Mastectomy: Is It Safe for Patients with Locally Advanced Disease?

et al. 2015

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“…Characteristics such as tumor size, histologic type, staging, location, human epidermal growth factor receptor 2 (HER2) amplification, lymphovascular invasion, intraductal spread, and clinical appearance of the NAC (including the presence of nipple discharge) all have been shown to affect tumor involvement of the NAC. 12 Pathologic studies of patients undergoing NSSM or TSSM have reported a wide range of NAC involvement risk ranging from 2.5 to 14 %. 2,10,11,[13][14][15] Few data exist on the optimal way to manage TSSM cases with NAC involvement or on the oncologic outcomes for these patients, particularly in highrisk populations.…”

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Tumor Involvement of the Nipple in Total Skin-Sparing Mastectomy: Strategies for Management

et al. 2015

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“…10,11 Many studies have recommended that NSM only be performed in patients with peripheral tumors located no closer than 5 cm to the NAC. 2 Several studies have described NAC necrosis after NSM.…”

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Application of Nipple-Areolar Complex Impending Necrosis with Light-Emitting Diode Treatment for Immediate Breast Reconstruction after Nipple-Sparing Mastectomy

Yoon

Park

et al. 2017

Medical Lasers

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Background and ObjectivesNecrosis of the nipple-areolar complex (NAC) is a devastating complication of reconstructive breast surgery. Noncontact, Lightemitting diode (LED) phototherapy is an attractive therapy that promotes wound healing by stimulating the fibroblasts and increasing cell activities of the wound bed. We investigated the clinical efficacy of LED phototherapy to minimize nipple-areolar complex necrosis after nipplesparing mastectomy with immediate breast reconstruction. Materials and MethodsThen patients received LED phototherapy. OMEGA Light ® (Esmedi global, Seoul, Korea) has 4 different wavelengths that ranged from 423 nm to 640 nm. A 640 nm LED red light source was used. Patients received LED phototherapy for 20 minutes, twice a day, until postoperative week one. To reduce bacterial contamination and promote quick granulation and reepithelization, wound dressings were changed twice a day after phototherapy. ResultsPatients at risk of NAC ischemia showed clinical signs, including discoloration, edema of the nipple, and altered capillary refilling within the first 24 hours. Although NAC appeared to be ischemic and started to demarcate in the early postoperative period, there were no significant tissue loss. All ischemic NACs healed by secondary intention. Despite the presence of some demarcated areas in the early postoperative period, natural-looking NACs were restored in all breasts. ConclusionThe use of LED inducing a photobiomodulative reaction to ischemic NACs after breast reconstruction can be effective in reducing postoperative NAC full thickness necrosis and improving wound healing.

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Risk of Locoregional Recurrence in Patients With False-Negative Frozen Section or Close Margins of Retroareolar Specimen in Nipple-Sparing Mastectomy

Abstract: Despite a high reliability of frozen section, there is still a minority of false-negative results. Nevertheless, the LRR is considerably low. This fact suggests the possibility of preservation of the NAC after discussion with the patient.

Cited by 53 publications

References 42 publications

Expanding the Indications for Total Skin-Sparing Mastectomy: Is It Safe for Patients with Locally Advanced Disease?

Expanding the Indications for Total Skin-Sparing Mastectomy: Is It Safe for Patients with Locally Advanced Disease?

Tumor Involvement of the Nipple in Total Skin-Sparing Mastectomy: Strategies for Management

Application of Nipple-Areolar Complex Impending Necrosis with Light-Emitting Diode Treatment for Immediate Breast Reconstruction after Nipple-Sparing Mastectomy

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