Women with mutations in breast cancer predisposition genes have a significantly higher lifetime risk of developing breast cancer and can opt for risk-reducing mastectomy. Women with positive family history of cancer can also opt for prophylactic surgery as a preventive method in selected cases. Current studies showed reduced risk of developing breast cancer after prophylactic nipple-sparing mastectomy, however, despite the good clinical outcomes, one of the main concerns regarding nipple-sparing mastectomy (NSM) is the oncological safety of nipple-areola complex preservation. In this study, we aimed to evaluate the indications, complication rates, and unfavorable events of 62 Brazilian patients that underwent risk-reducing NSM from 2004 to 2018.
Patient data were reviewed retrospectively and descriptive statistics were utilized to summarize the findings.
The mean patients age was 43.8 years. The main indication for risk-reducing NSM was the presence of pathogenic mutation (53.3%), followed by atypia or lobular carcinoma in situ (25.8), and family history of breast cancer and/or ovarian cancer (20.9%). There were four (3.2%) incidental diagnosis of ductal carcinoma in situ and one invasive ductal carcinoma (0.8%). From the 124 prophylactic NSM performed, two (1.6%) complications had occurred: one (0.8%) infection and one (0.8%) partial nipple necrosis. In a mean follow-up of 50 months, there was one (1.6%) newly diagnosed breast cancer in the 62 patients undergoing prophylactic NSM.
Our findings demonstrated efficacy and safety to perform NSM as prophylactic surgery with good oncological outcomes and low complication rates in a case series of Brazilian patients.
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The authors disclosure that they have no commercial interest in the subject of study and received no financial or material support for the study.
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The authors declare that they have no conflict of interest.
All procedures performed in the study were in accordance with the ethical standards by the Institutional Ethics Committee of Pontifical Catholic University of Rio Grande do Sul (PUCRS), Hospital Albert Einstein and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Frasson, A.L., Lichtenfels, M., de Souza, A.A.B. et al. Risk-reducing mastectomy: a case series of 124 procedures in Brazilian patients. Breast Cancer Res Treat 181, 69–75 (2020). https://doi.org/10.1007/s10549-020-05582-w
- Prophylactic surgical procedures
- Genetic predisposition to disease
- Subcutaneous mastectomy
- Breast neoplasm