Evolution and time trends of nipple-sparing mastectomy: a single-center experience
- PDF / 719,878 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 22 Downloads / 165 Views
ORIGINAL ARTICLE
Evolution and time trends of nipple‑sparing mastectomy: a single‑center experience Erika Barbieri1 · Federico Frusone2 · Alberto Bottini1 · Andrea Sagona1 · Wolfgang Gatzemeier1 · Giuseppe Canavese1 · Chiara Annunziata Pasqualina Anghelone1 · Alessandro De Luca2 · Emilia Marrazzo1 · Maria Ida Amabile2 · Corrado Tinterri1 Received: 29 October 2019 / Accepted: 9 May 2020 © Italian Society of Surgery (SIC) 2020
Abstract Nipple Sparing Mastectomy (NSM) requires the entire breast tissue to be removed, maintaining the nipple-areola complex, and represents nowadays the gold standard of the demolitive breast surgery. Although it represents the evolution of conservative breast surgery, NSM presents some limitations in the selection of women candidates for treatment, and still there are no real guidelines regarding its indications, but simply objective data to address the choice. How the breast surgery approach to demolitive and conservative surgery has changed over time? We evaluated throughout the years (from 2009 up to 2018) the time trend of NSM at our institution and analysed the main differences between patients undergone NSM and other mastectomies and/or breast conserving surgery in terms of cancer size, multicentricity and biological profile. We found 781 NSMs, 1261 other mastectomies and 5621 breast conservative surgeries. Among NSMs, 39.6% were reconstructed with tissue expander and 58.1% with definitive prosthesis. From 2009 to 2018 we found a general increase of NSM rate (from 21.3% of all mastectomies in 2009 to 67.3% in 2018) and a decrease of total mastectomies (from 78.7% of all mastectomies in 2009 to 32.7% in 2018). In line with the literature data, our data confirm that in the recent years NSM represents the gold standard for radical breast surgery. Undisputed in prophylaxis, NSM is continuously acquiring more support in being used as first line treatment for locally advanced disease. Keywords Nipple Sparing Mastectomy · Mastectomy · Breast cancer · Breast surgery Abbreviations NSM Nipple Sparing Mastectomy NAC Nipple-Areola Complex BCS Breast-Conserving Surgery pCR Pathologic Complete Response
Background Despite the development and evolution of innovative techniques concerning the early detection of breast cancer, there are still some conditions in which mastectomy represents the
* Federico Frusone [email protected] 1
Breast Surgery Department, Humanitas Research Hospital and Cancer Center, Rozzano, Milan, Italy
Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
2
best possible treatment, including management of high-risk woman (i.e., carriers of BRCA1-2 mutations) [1]. In the last years, surgery has evolved and nipple-sparing-mastectomy (NSM) technique in selected cases may be defined as the gold standard when it is not possible to maintain a more conservative approach [2]. It has to be considered which are the main issues concerning this technique and how it has evolved over time. The use of NSM technique has increased among major int
Data Loading...
