Breast Cancer Oncological Outcomes at an Italian Center Following Nipple-Sparing and Skin-Sparing Mastectomy Techniques
Background: The introduction of skin-sparing mastectomy (SSM) and nipple-sparing mastectomy (NSM) with immediate reconstruction allowed a noticeable improvement in reconstructive surgery aesthetic results and patients’ psychophysical well-being. In any case, there are still concerns about the long-t...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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IMR Press
2023-05-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
| Subjects: | |
| Online Access: | https://www.imrpress.com/journal/CEOG/50/5/10.31083/j.ceog5005094 |
| _version_ | 1827936262134169600 |
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| author | Serena Bertozzi Ambrogio Pietro Londero Luca Seriau Federica Passafiume Sara Moschella Vittoria Morinelli Michela Andretta Maria Orsaria Laura Mariuzzi Pier Camillo Parodi Andrea Risaliti Carla Cedolini |
| author_facet | Serena Bertozzi Ambrogio Pietro Londero Luca Seriau Federica Passafiume Sara Moschella Vittoria Morinelli Michela Andretta Maria Orsaria Laura Mariuzzi Pier Camillo Parodi Andrea Risaliti Carla Cedolini |
| author_sort | Serena Bertozzi |
| collection | DOAJ |
| description | Background: The introduction of skin-sparing mastectomy (SSM) and nipple-sparing mastectomy (NSM) with immediate reconstruction allowed a noticeable improvement in reconstructive surgery aesthetic results and patients’ psychophysical well-being. In any case, there are still concerns about the long-term oncological safety of these two procedures. This study aims to assess the oncological outcomes of women who underwent SSM and NSM and to compare them with traditional modified total mastectomy (MTM). The secondary outcome was to compare mastectomy with breast-conserving surgery (BCS) outcome. Methods: We performed a retrospective chart review study concerning all patients who had experienced SSM and NSM in our Clinic between January 2004 and July 2013. The main outcomes were overall survival (OS), disease-free survival (DFS), and recurrences cumulative rate. Results: Among this study’s 1836 invasive breast carcinomas, we found NSM (86.7, 95% confidence interval (CI), 76.7–98.0%) to have a significantly shorter 5-year DFS than MTM (90.4%, 95% CI, 87.9–93.0%). Furthermore, low body mass index (odds ratio (OR) 0.733, p = 0.056), basal-like molecular subtype (OR 28.932, p < 0.05), extended intraductal component (OR 11.160, p = 0.107), and lymph node metastasis extracapsular invasion (OR 8.727, p = 0.077) were the most significant predictors of recurrence in women treated with NSM. Furthermore, patients with BCS had significantly longer OS and DFS than those who underwent MTM. Conclusions: Occult nipple neoplastic involvement following negative intraoperative histological examination of subareolar tissue may explain the higher recurrence rate among women undergoing NSM. Patients with one or more risk factors for recurrence after NSM, such as basal-like molecular subtype, extended intraductal component, and extracapsular invasion of lymph node metastasis, should be given special attention. |
| first_indexed | 2024-03-13T08:08:38Z |
| format | Article |
| id | doaj.art-b000ee68154f4cb28b96927ed00dabfb |
| institution | Directory Open Access Journal |
| issn | 0390-6663 |
| language | English |
| last_indexed | 2024-03-13T08:08:38Z |
| publishDate | 2023-05-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj.art-b000ee68154f4cb28b96927ed00dabfb2023-06-01T02:24:25ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632023-05-015059410.31083/j.ceog5005094S0390-6663(23)02080-8Breast Cancer Oncological Outcomes at an Italian Center Following Nipple-Sparing and Skin-Sparing Mastectomy TechniquesSerena Bertozzi0Ambrogio Pietro Londero1Luca Seriau2Federica Passafiume3Sara Moschella4Vittoria Morinelli5Michela Andretta6Maria Orsaria7Laura Mariuzzi8Pier Camillo Parodi9Andrea Risaliti10Carla Cedolini11Breast Unit, Academic Hospital of Udine, 33100 Udine, ItalyDepartment of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Infant Health, University of Genoa, 16132 Genova, ItalyBreast Unit, Academic Hospital of Udine, 33100 Udine, ItalyBreast Unit, Academic Hospital of Udine, 33100 Udine, ItalyBreast Unit, Academic Hospital of Udine, 33100 Udine, ItalyBreast Unit, Academic Hospital of Udine, 33100 Udine, ItalyBreast Unit, Academic Hospital of Udine, 33100 Udine, ItalyInstitute of Pathologic Anatomy, DAME, Academic Hospital of Udine, 33100 Udine, ItalyInstitute of Pathologic Anatomy, DAME, Academic Hospital of Udine, 33100 Udine, ItalyClinic of Plastic Surgery, DAME, Academic Hospital of Udine, 33100 Udine, ItalyClinic of Surgery, DAME, University of Udine, 33100 Udine, ItalyBreast Unit, Academic Hospital of Udine, 33100 Udine, ItalyBackground: The introduction of skin-sparing mastectomy (SSM) and nipple-sparing mastectomy (NSM) with immediate reconstruction allowed a noticeable improvement in reconstructive surgery aesthetic results and patients’ psychophysical well-being. In any case, there are still concerns about the long-term oncological safety of these two procedures. This study aims to assess the oncological outcomes of women who underwent SSM and NSM and to compare them with traditional modified total mastectomy (MTM). The secondary outcome was to compare mastectomy with breast-conserving surgery (BCS) outcome. Methods: We performed a retrospective chart review study concerning all patients who had experienced SSM and NSM in our Clinic between January 2004 and July 2013. The main outcomes were overall survival (OS), disease-free survival (DFS), and recurrences cumulative rate. Results: Among this study’s 1836 invasive breast carcinomas, we found NSM (86.7, 95% confidence interval (CI), 76.7–98.0%) to have a significantly shorter 5-year DFS than MTM (90.4%, 95% CI, 87.9–93.0%). Furthermore, low body mass index (odds ratio (OR) 0.733, p = 0.056), basal-like molecular subtype (OR 28.932, p < 0.05), extended intraductal component (OR 11.160, p = 0.107), and lymph node metastasis extracapsular invasion (OR 8.727, p = 0.077) were the most significant predictors of recurrence in women treated with NSM. Furthermore, patients with BCS had significantly longer OS and DFS than those who underwent MTM. Conclusions: Occult nipple neoplastic involvement following negative intraoperative histological examination of subareolar tissue may explain the higher recurrence rate among women undergoing NSM. Patients with one or more risk factors for recurrence after NSM, such as basal-like molecular subtype, extended intraductal component, and extracapsular invasion of lymph node metastasis, should be given special attention.https://www.imrpress.com/journal/CEOG/50/5/10.31083/j.ceog5005094breast cancernipple-sparing mastectomyskin-sparing mastectomydisease-free survivalbreast-conserving surgerymodified total mastectomyoverall survivallocal recurrence |
| spellingShingle | Serena Bertozzi Ambrogio Pietro Londero Luca Seriau Federica Passafiume Sara Moschella Vittoria Morinelli Michela Andretta Maria Orsaria Laura Mariuzzi Pier Camillo Parodi Andrea Risaliti Carla Cedolini Breast Cancer Oncological Outcomes at an Italian Center Following Nipple-Sparing and Skin-Sparing Mastectomy Techniques Clinical and Experimental Obstetrics & Gynecology breast cancer nipple-sparing mastectomy skin-sparing mastectomy disease-free survival breast-conserving surgery modified total mastectomy overall survival local recurrence |
| title | Breast Cancer Oncological Outcomes at an Italian Center Following Nipple-Sparing and Skin-Sparing Mastectomy Techniques |
| title_full | Breast Cancer Oncological Outcomes at an Italian Center Following Nipple-Sparing and Skin-Sparing Mastectomy Techniques |
| title_fullStr | Breast Cancer Oncological Outcomes at an Italian Center Following Nipple-Sparing and Skin-Sparing Mastectomy Techniques |
| title_full_unstemmed | Breast Cancer Oncological Outcomes at an Italian Center Following Nipple-Sparing and Skin-Sparing Mastectomy Techniques |
| title_short | Breast Cancer Oncological Outcomes at an Italian Center Following Nipple-Sparing and Skin-Sparing Mastectomy Techniques |
| title_sort | breast cancer oncological outcomes at an italian center following nipple sparing and skin sparing mastectomy techniques |
| topic | breast cancer nipple-sparing mastectomy skin-sparing mastectomy disease-free survival breast-conserving surgery modified total mastectomy overall survival local recurrence |
| url | https://www.imrpress.com/journal/CEOG/50/5/10.31083/j.ceog5005094 |
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