Breast Cancer

, Volume 23, Issue 6, pp 851–860 | Cite as

Oncologic outcomes and technical considerations of nipple-sparing mastectomies in breast cancer: experience of 425 cases from a single institution

  • Ayaka Shimo
  • Koichiro Tsugawa
  • Seiko Tsuchiya
  • Reiko Yoshie
  • Kyoko Tsuchiya
  • Tomoko Uejima
  • Yasuyuki Kojima
  • Arata Shimo
  • Ryosuke Hayami
  • Toru Nishikawa
  • Yukari Yabuki
  • Hisanori Kawamoto
  • Akihiko Sudo
  • Mamoru Fukuda
  • Yoshihide Kanemaki
  • Ichiro Maeda
Original Article

Abstract

Background

Nipple-sparing mastectomy (NSM) is an advantageous treatment option, providing a complete cure and good cosmetic results. We tested whether NSM is a surgically and oncologically safe technique.

Methods

We evaluated the oncological outcome of 425 breasts in 413 patients who underwent NSM between January 2000 and March 2013. We retrospectively reviewed patient data and analyzed all patient characteristics as potential risk factors of recurrence at the nipple–areola complex (NAC). To confirm the oncological safety of NSM, we compared outcomes of NSM and conventional total mastectomy.

Results

The median follow-up time after surgery was 46.8 months (range 6–158 months). Nipple necrosis was observed in 6 cases (1.4 %). The cumulative local recurrence rate after NSM was 5.8 % (25/425 cases), similar to that of conventional total mastectomy in the same period (5.6 %, 49/878 cases). Furthermore, the cumulative local recurrence rate at the NAC was 2.3 % (10 cases). HER2-enriched tumors and young age (<40 years) were significant risk factors for recurrence at the NAC. In patients with recurrence, the site of recurrence was easily excised, and good cosmetic results were achieved in breast reconstruction cases.

Conclusion

NSM is safe with a low complication rate. No significant difference was observed in cumulative local recurrence rate, cumulative distant disease recurrence rate, and overall survival between patients who underwent NSM or conventional total mastectomy, confirming that NSM was surgically and oncologically safe.

Keywords

Nipple-sparing mastectomy NSM Total mastectomy Local recurrence Survival 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© The Japanese Breast Cancer Society 2015

Authors and Affiliations

  • Ayaka Shimo
    • 1
  • Koichiro Tsugawa
    • 1
  • Seiko Tsuchiya
    • 1
  • Reiko Yoshie
    • 1
  • Kyoko Tsuchiya
    • 1
  • Tomoko Uejima
    • 1
  • Yasuyuki Kojima
    • 1
  • Arata Shimo
    • 1
  • Ryosuke Hayami
    • 1
  • Toru Nishikawa
    • 1
  • Yukari Yabuki
    • 1
  • Hisanori Kawamoto
    • 1
    • 2
  • Akihiko Sudo
    • 2
  • Mamoru Fukuda
    • 2
  • Yoshihide Kanemaki
    • 3
  • Ichiro Maeda
    • 4
  1. 1.Department of Breast and Endocrine SurgerySt. Marianna University School of MedicineKawasaki-ShiJapan
  2. 2.Breast and Imaging CenterSt. Marianna University School of MedicineKanagawaJapan
  3. 3.Department of RadiologySt. Marianna University School of MedicineKanagawaJapan
  4. 4.Department of PathologySt. Marianna University School of MedicineKanagawaJapan

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