Original scientific articleNipple-Sparing Mastectomy for Breast Cancer and Risk Reduction: Oncologic or Technical Problem?
Section snippets
Protocol
We retrospectively analyzed data on 123 patients who underwent nipple-sparing mastectomy with breast reconstruction for either prophylaxis or treatment of breast cancer at Memorial Sloan-Kettering Cancer Center, New York; the Department of Obstetrics and Gynecology, Sao Paulo University, Sao Paulo, Brazil; the European Institute of Oncology, Milan, Italy; or the Department of Surgical Sciences, University of Padua, Padua, Italy.
Assignment
Patient records were retrieved from clinical databases at these
Results
Fourteen patients who underwent nipple-sparing mastectomy for invasive cancer or DCIS, and had cancers > 1 cm away from the areola, showed involvement of the retroareolar ducts, mainly by DCIS, at final pathology. In these patients, the nipple and areolar complex was removed during an additional procedure within 40 days after the nipple-sparing procedure. These 14 patients were excluded from our study (Table 1).
One hundred twenty-three patients underwent nipple-sparing mastectomy: 55 for
Discussion
Subcutaneous mastectomy for primary breast cancer or risk reduction is not a new procedure. In 1962, Freeman13, 14 pioneered this surgical procedure, but it was eventually abandoned because of the high rate of complications and lingering questions about its oncologic safety. Many of these early concerns have been addressed.1, 8 Frequently cited in the literature, the classic subcutaneous mastectomy, which is a nipple-sparing procedure, has been criticized because of the increased likelihood of
Acknowledgment
We would like to thank Jane V Fey, MPH and Myra Partridge for their help in the writing and preparation of this article.
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Competing Interests Declared: None.