Abstract
The majority of the surgical literature describing institutional experience with nipple-sparing mastectomy (NSM) has come from academic institutions. Little has been published by community-based surgeons who are responsible for more than 80 % of breast cancer surgical treatment in the United States. This chapter describes the experience of a single breast surgeon (JKH) over the past 11 years in the community setting as a member of a comprehensive multidisciplinary breast program. Early on, a more assertive approach was taken to include patients that others felt were not candidates for NSM. Overall, 374 areolar or nipple-areolar sparing mastectomies were performed in 237 patients. The loco-regional recurrence rates and complication profile were comparable to what is reported in the peer-reviewed literature. We hope that this will inspire other community programs to publish their experiences as a means of reinforcing the safety of NSM in the community setting.
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References
Spear SL, Hannan CM, Willey SC, Cocilovo C. Nipple-sparing mastectomy. Plast Reconstr Surg. 2009;123(6):1665–73.
Peled AW, Wang F, Foster RD, Alvarado M, Ewing CA, Sbitany H, Esserman LJ. Expanding the indications for total skin-sparing mastectomy: is it safe for patients with locally advanced disease? Ann Surg Oncol. 2015;23(1):87–91. doi:10.1245/s10434-015-4734-6.
Harness JK, Vetter TS, Salibian AH. Areola and nipple-areola-sparing mastectomy for breast cancer treatment and risk reduction: report of an initial experience in a community hospital setting. Ann Surg Oncol. 2011;18:917–22.
Stolier AJ, Sullivan SK, Dellacroce FJ. Technical considerations in nipple-sparing mastectomy: 82 consecutive cases without necrosis. Ann Surg Oncol. 2008;15(5):1341–7.
Menzies D, Barr L, Ellis H. Paget’s disease of the nipple occurring after wide local excision and radiotherapy for carcinoma of the breast. Eur J Surg Oncol. 1989;15:271.
Schnitt SJ, Connolly JL, Recht A, Silver B, Harris JR. Breast relapse following primary radiation therapy for early breast cancer. II. Detection, pathologic features and prognostic significance. Int J Radiat Oncol Biol Phys. 1985;11:1277–84.
Peterse JL, van Dongen JA, Bartelink H. Recurrence of breast carcinoma after breast conserving treatment. Eur J Surg Oncol. 1988;14:123–6.
Plastaras JP, Harris EE, Solin LJ. Paget’s disease of the nipple as local recurrence after breast-conservation treatment for early-stage breast cancer. Clin Breast Cancer. 2005;6:349–53.
Lohsiriwat V, Martella S, Rietjens M, Botteri E, Rotmensz N, Mastropasqua MG, et al. Paget’s disease as a local recurrence after nipple-sparing mastectomy: clinical presentation, treatment, outcome and risk factor analysis. Ann Surg Oncol. 2012;19:1850–5.
Fersis N, Hoenig A, Relakis K, Pinin S, Wallwienr D. Skin-sparing mastectomy and immediate breast reconstruction: incidence of recurrence in patients with invasive breast cancer. Breast J. 2004;13:488–93.
Medina-Franco H, Vasconez LO, Fix RJ, Heslin MJ, Bland KI, Urist MM. Factors associated with local recurrence after skin-sparing mastectomy and immediate breast reconstruction for invasive breast cancer. Ann Surg. 2002;235(6):814–9.
Mallon P, Feron JG, Couturaud B, Fitoussi A, Lemasurier P, Guihard T, et al. The role of nipple-sparing mastectomy in breast cancer: a comprehensive review of the literature. Plast Reconstr Surg. 2013;131(5):969–84.
Wang F, Peled AW, Garwood E, Fiscalini AS, Sbitani H, Foster R, et al. Total skin-sparing mastectomy and immediate breast reconstruction: an evolution of technique and assessment of outcomes. Ann Surg Oncol. 2014;21:3223–30.
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Mowlds, D.S., Harness, J.K., Salibian, A.H., McNally, R.S. (2017). Nipple-Sparing Mastectomy in the Community Setting. In: Harness, J., Willey, S. (eds) Operative Approaches to Nipple-Sparing Mastectomy. Springer, Cham. https://doi.org/10.1007/978-3-319-43259-5_8
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DOI: https://doi.org/10.1007/978-3-319-43259-5_8
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