| Autor: |
Thaweepworadej, Panya, Chirappapha, Prakasit, Lertsithichai, Panuwat, Sukarayothin, Thongchai, Leesombatpaiboon, Monchai |
| Zdroj: |
Thai Journal of Surgery; Apr-Jun2022, Vol. 43 Issue 2, p49-56, 8p |
| Abstrakt: |
Objectives: There are relatively few studies of locoregional recurrence (LRR) after nipple-sparing mastectomy (NSM) for breast cancer. The aim of the present study was to determine the oncologic safety of nippleareolar complex (NAC)-sparing mastectomy in breast cancer patients and to determine risk factors for LRR. Patients and Methods: We analyzed 65 NSMs that were performed on 63 patients for both therapeutic and prophylactic indications between January 2007 and June 2017. Patient demographics, operative details, oncologic outcomes, and postoperative complications were recorded. Factors associated with LRR were also analyzed. Results: The mean age of the patients was 43 years (range, 30 to 61 years). Fifty-eight NSMs (89%) were performed for cancer treatment. Skin necrosis was the most common complication (19%), but most cases were successfully managed conservatively. Fifty-one NSMs were included in the oncologic evaluation. Forty of 51patients (78%) underwent surgery for invasive breast cancer, and the rest had carcinoma in situ. After a mean follow-up period of 70 months (24 to 162 months), four patients (8%) developed LRR, with mostly in the regional lymph nodes. Only one patient developed Paget’s disease of the nipple after surgery and required NAC excision. Five-year disease-free survival was 87%. In a subgroup analysis, only tumor size and Ki-67 level showed an association with LRR, but only Ki-67 level was statistically significant (HR 1.07; 95% CI 1.00 to 1.15). Conclusion: NSM is oncologically safe and is technically feasible in selected patients. A low rate of LRR was also observed. Only Ki-67 level showed an association with LRR. Long-term outcomes should be closely monitored. [ABSTRACT FROM AUTHOR] |
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