Necrotic Complications after Nipple- and Areola-Sparing Mastectomy
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The objective was to analyze the frequency and factors influencing necrotic complication in female patients undergoing nipple- and areola-sparing mastectomy.
Summary and background data
Nipple- and areola-sparing mastectomy has recently been shown to yield satisfactory results in a carefully selected group of breast cancer patients. The technique includes extensive undermining of the nipple–areola complex, which may result in an increased rate of necrotic complications. We report our early experience with necrotic changes after nipple- and areola-sparing mastectomy.
The medical records of 38 patients undergoing nipple- and areola-sparing mastectomy were analyzed retrospectively.
Mean age of the patient was 44.5 years (range 26–65). Necrotic complications occurred in 15.8% of patients and included: skin flap necrosis (1 case), partial nipple–areola complex necrosis (2 cases), and complete nipple–areola complex necrosis (3 cases). Two cases of capsular contraction were also recorded. Statistical analysis showed age below 45 years to be associated with a lower risk of necrotic complications (OR 4.51, P < 0.05).
The nipple- and areola-sparing mastectomy, although resulting in a relatively high frequency of necrotic complications, is a valuable surgical option for patients with small, peripheral tumors and for women undergoing prophylactic mastectomy. The procedure seems to be safer for women under 45 years of age.
KeywordsBreast Reconstruction Prophylactic Mastectomy Positive Sentinel Node Capsular Contracture Sentinel Node Procedure
This work has been supported by a UICC International Cancer Technology Transfer Fellowship and with Federal funds from the National Cancer Institute, National Institutes of Health, under Contract NO2-CO-91012.