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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2017 October;176(10):497-503

DOI: 10.23736/S0393-3660.17.03435-0

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Nipple sparing mastectomy: when oncologic feasibility meets aesthetic outcome. A single center experience

Francesca MAZZARELLA 1, 2, Antonio PALUDETTI 1, Mara GIOVANELLI 1 , Emanuela M. MAURI 1, Silvia TAKANEN 3, Bernardo RIGHI 4, Luigi F. CAZZANIGA 3, Privato FENAROLI 1

1 Department of Breast Surgery, ASST Papa Giovanni XXIII, Bergamo, Italy; 2 Emergency Department, Ospedale Carlo Poma, Mantova, Italy; 3 Department of Radiotherapy, ASST Papa Giovanni XXIII, Bergamo, Italy; 4 Department of Plastic Surgery, ASST Papa Giovanni XXIII, Bergamo, Italy


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BACKGROUND: Nipple-sparing mastectomy (NSM) has been increasingly used to treat women with breast cancer, but concern remains regarding tumor recurrence. The preservation of the skin envelope and the nipple-areola complex (NAC) preservation decrease the feeling of mutilation and enhance the quality of reconstruction. The aim of this study is to analyze the overall and disease free survival, the loco-regional recurrence and the systemic relapse rates according to the published data and to evaluate the aesthetic outcome.
METHODS: A retrospective chart review on patients undergoing NSM from 2005 -2012. Statistical comparisons used t test, Z test, chi-squared test and Fisher’s exact test. The Kaplan-Meier method was used to calculate the oncological outcome. The final aesthetic evaluation was rated by the surgeon and the patient according to a scale 0-10.
RESULTS: We identified 94 consecutive NSM patients. Sixteen (17%) postoperative complications were recorded (4 hematomas, 7 infections, one transient ischemia of the skin, one expander ropture, 2 complete NAC necrosis and one transient NAC ischemia). Median follow up was 59.5 months. The overall survival was 98.3% and the disease free survival was 91.5% at 5 years. We observed 6 systemic recurrence (6.4%) and 3 local or regional relapse (3.2%). In our study 54 patients had a final aesthetic evaluation. Patient and surgeon rated the overall result similarly.
CONCLUSIONS: NMS is a safe option for women with breast cancer with acceptable aesthetic results and good patient satisfaction and does not seem to increase recurrence or diminish survival.


KEY WORDS: Mastectomy - Breast neoplasms - Recurrence

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