Top

Published in:

01-09-2020 | Breast Surgery | Original Article

Evolution and time trends of nipple-sparing mastectomy: a single-center experience

Authors: Erika Barbieri, Federico Frusone, Alberto Bottini, Andrea Sagona, Wolfgang Gatzemeier, Giuseppe Canavese, Chiara Annunziata Pasqualina Anghelone, Alessandro De Luca, Emilia Marrazzo, Maria Ida Amabile, Corrado Tinterri

Published in: Updates in Surgery | Issue 3/2020

Abstract

Nipple Sparing Mastectomy (NSM) requires the entire breast tissue to be removed, maintaining the nipple-areola complex, and represents nowadays the gold standard of the demolitive breast surgery. Although it represents the evolution of conservative breast surgery, NSM presents some limitations in the selection of women candidates for treatment, and still there are no real guidelines regarding its indications, but simply objective data to address the choice. How the breast surgery approach to demolitive and conservative surgery has changed over time? We evaluated throughout the years (from 2009 up to 2018) the time trend of NSM at our institution and analysed the main differences between patients undergone NSM and other mastectomies and/or breast conserving surgery in terms of cancer size, multicentricity and biological profile. We found 781 NSMs, 1261 other mastectomies and 5621 breast conservative surgeries. Among NSMs, 39.6% were reconstructed with tissue expander and 58.1% with definitive prosthesis. From 2009 to 2018 we found a general increase of NSM rate (from 21.3% of all mastectomies in 2009 to 67.3% in 2018) and a decrease of total mastectomies (from 78.7% of all mastectomies in 2009 to 32.7% in 2018). In line with the literature data, our data confirm that in the recent years NSM represents the gold standard for radical breast surgery. Undisputed in prophylaxis, NSM is continuously acquiring more support in being used as first line treatment for locally advanced disease.

Amabile MI, Monti M, Merola R, Frusone F, D'Orazi V, Pasta V (2016) Nipple-sparing mastectomy in patients with preoperative diagnosis of non-invasive breast carcinoma. A Single-center Experience Anticancer Res 36(2):779–783PubMed

Sacchini V, Pinotti JA, Barros AC, Luini A, Pluchinotta A, Pinotti M, Boratto MG, Ricci MD, Ruiz CA, Nisida AC, Veronesi P, Petit J, Arnone P, Bassi F, Disa JJ, Garcia-Etienne CA, Borgen PI (2006) Nipple-sparing mastectomy for breast cancer and risk reduction: oncologic or technical problem. J Am Coll Surg 203(5):704–714. https://doi.org/10.1016/j.jamcollsurg.2006.07.015PubMedCrossRef

Galimberti V, Vicini E, Corso G, Morigi C, Fontana S, Sacchini V, Veronesi P (2017) Nipple-sparing and skin-sparing mastectomy: review of aims, oncological safety and contraindications. Breast 34(Suppl 1):S82–S84. https://doi.org/10.1016/j.breast.2017.06.034PubMedPubMedCentralCrossRef

Fortunato L, Loreti A, Andrich R, Costarelli L, Amini M, Farina M, Santini E, Vitelli CE (2013) When mastectomy is needed: is the nipple-sparing procedure a new standard with very few contraindications. J Surg Oncol 108(4):207–212. https://doi.org/10.1002/jso.23390PubMedCrossRef

Toth BA, Lappert P (1991) Modified skin incisions for mastectomy: the need for plastic surgical input in preoperative planning. Plast Reconstr Surg 87(6):1048–1053PubMedCrossRef

Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, Aguilar M, Marubini E (2002) 20-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 347(16):1227–1232. https://doi.org/10.1056/NEJMoa020989PubMedCrossRef

Suarez-Zamora DA, Barrera-Herrera LE, Palau-Lazaro MA, Torres-Franco F, Orozco-Plazas A, Barreto-Hauzeur L, Rodriguez-Urrego PA (2017) Accuracy and interobserver agreement of retroareolar frozen sections in nipple-sparing mastectomies. Ann Diagn Pathol 29:46–51. https://doi.org/10.1016/j.anndiagpath.2017.05.001PubMedCrossRef

Pasta V, D'Orazi V, Merola R, Frusone F, Amabile MI, De Luca A, Buè R, Monti M (2016) Oncoplastic central quadrantectomies. Gland Surg 5(4):422–426. https://doi.org/10.21037/gs.2016.04.01PubMedPubMedCentralCrossRef

Smith BL, Tang R, Rai U, Plichta JK, Colwell AS, Gadd MA, Specht MC, Austen WG, Coopey SB (2017) Oncologic safety of nipple-sparing mastectomy in women with breast cancer. J Am Coll Surg 225(3):361–365. https://doi.org/10.1016/j.jamcollsurg.2017.06.013PubMedCrossRef

10.

Headon HL, Kasem A, Mokbel K (2016) The oncological safety of nipple-sparing mastectomy: a systematic review of the literature with a pooled analysis of 12,358 procedures. Arch Plast Surg 43(4):328–338. https://doi.org/10.5999/aps.2016.43.4.328PubMedPubMedCentralCrossRef

11.

De La Cruz L, Moody AM, Tappy EE, Blankenship SA, Hecht EM (2015) Overall survival, disease-free survival, local recurrence, and nipple-areolar recurrence in the setting of nipple-sparing mastectomy: a meta-analysis and systematic review. Ann Surg Oncol 22(10):3241–3249. https://doi.org/10.1245/s10434-015-4739-1CrossRef

12.

Agarwal S, Agarwal S, Neumayer L, Agarwal JP (2014) Therapeutic nipple-sparing mastectomy: trends based on a national cancer database. Am J Surg 208(1):93–98. https://doi.org/10.1016/j.amjsurg.2013.09.030PubMedCrossRef

13.

Pasta V, Mitri F, Amabile MI, Picardi N (2006) Inflammatory breast cancer. Ann Ital Chir 77(3):275–279PubMed

14.

Weber WP, Haug M, Kurzeder C, Bjelic-Radisic V, Koller R, Reitsamer R, Fitzal F, Biazus J, Brenelli F, Urban C et al (2018) Oncoplastic breast consortium consensus conference on nipple-sparing mastectomy. Breast Cancer Res Treat 172(3):523–537. https://doi.org/10.1007/s10549-018-4937-1PubMedPubMedCentralCrossRef

15.

Palmieri A, D'Orazi V, Martino G, Frusone F, Crocetti D, Amabile MI, Monti M (2016) Plasma cell mastitis in men: a single-center experience and review of the literature. In Vivo 30(6):727–732. https://doi.org/10.21873/invivo.10987PubMedCrossRef

16.

National Comprehensive Cancer Network (NCCN) (2019) Guidelines for breast cancer. https://www.nccn.org/professionals/physician_gls/default.aspx#site. Accessed 1 Mar 2019

17.

Zhang H, Li Y, Moran MS, Haffty BG, Yang Q (2015) Predictive factors of nipple involvement in breast cancer: a systematic review and meta-analysis. Breast Cancer Res Treat 151(2):239–249. https://doi.org/10.1007/s10549-015-3385-4PubMedCrossRef

18.

Smith BL, Coopey SB (2018) Nipple-sparing mastectomy. Adv Surg 52(1):113–126. https://doi.org/10.1016/j.yasu.2018.03.008PubMedCrossRef

19.

Peled AW, Sbitany H, Foster RD, Esserman LJ (2014) Oncoplastic mammoplasty as a strategy for reducing reconstructive complications associated with postmastectomy radiation therapy. Breast J 20(3):302–307. https://doi.org/10.1111/tbj.12257PubMedCrossRef

20.

Agresti R, Sandri M, Gennaro M, Bianchi G, Maugeri I, Rampa M, Capri G, Carcangiu ML, Trecate G, Riggio E, Lozza L, de Braud F (2017) Evaluation of local oncologic safety in nipple-areola complex-sparing mastectomy after primary chemotherapy: a propensity score-matched study. Clin Breast Cancer 17(3):219–231. https://doi.org/10.1016/j.clbc.2016.12.003PubMedCrossRef

21.

Amara D, Peled AW, Wang F, Ewing CA, Alvarado M, Esserman LJ (2015) Tumor involvement of the nipple in total skin-sparing mastectomy: strategies for management. Ann Surg Oncol 22(12):3803–3808. https://doi.org/10.1245/s10434-015-4646-5PubMedCrossRef

22.

Petit JY, Veronesi U, Orecchia R, Rey P, Martella S, Didier F, Viale G, Veronesi P, Luini A, Galimberti V, Bedolis R, Rietjens M, Garusi C, De Lorenzi F, Bosco R, Manconi A, Ivaldi GB, Youssef O (2009) Nipple sparing mastectomy with nipple areola intraoperative radiotherapy: one thousand and one cases of a 5-year experience at the European institute of oncology of Milan (EIO). Breast Cancer Res Treat 117(2):333–338. https://doi.org/10.1007/s10549-008-0304-yPubMedCrossRef

23.

D'Egidio V, Sestili C, Mancino M, Sciarra I, Cocchiara R, Backhaus I, Mannocci A, De Luca A, Frusone F, Monti M, La Torre G, Di Murro F, Palmeri V, Lia L, Paradiso G, Aceti V, Libia A (2017) Counseling interventions delivered in women with breast cancer to improve health-related quality of life: a systematic review. Qual Life Res 26(10):2573–2592. https://doi.org/10.1007/s11136-017-1613-6PubMedCrossRef

24.

Vitale SG, La Rosa VL, Rapisarda AMC, Laganà AS (2018) Fertility preservation in women with gynaecologic cancer: the impact on quality of life and psychological well-being. Hum Fertil (Camb) 21(1):35–38. https://doi.org/10.1080/14647273.2017.1339365CrossRef

25.

Laganà AS, La Rosa VL, Rapisarda AM, Platania A, Vitale SG (2017) Psychological impact of fertility preservation techniques in women with gynaecological cancer. Ecancermedicalscience. https://doi.org/10.3332/ecancer.2017.ed62PubMedPubMedCentralCrossRef

26.

Słowik AJ, Jabłoński MJ, Michałowska-Kaczmarczyk AM, Jach R (2017) Evaluation of quality of life in women with breast cancer, with particular emphasis on sexual satisfaction, future perspectives and body image, depending on the method of surgery. Psychiatr Pol 51(5):871–888. https://doi.org/10.12740/PP/OnlineFirst/63787PubMedCrossRef

27.

Vitale SG, Capriglione S, Zito G, Lopez S, Gulino FA, Di Guardo F, Vitagliano A, Noventa M, La Rosa VL, Sapia F et al (2019) Management of endometrial, ovarian and cervical cancer in the elderly: current approach to a challenging condition. Arch Gynecol Obstet 299(2):299–315. https://doi.org/10.1007/s00404-018-5006-zPubMedCrossRef

28.

Varghese F, Wong J (2018) Breast cancer in the elderly. Surg Clin North Am 98(4):819–833. https://doi.org/10.1016/j.suc.2018.04.002PubMedCrossRef

29.

Regolo L, Ballardini B, Gallarotti E, Scoccia E, Zanini V (2008) Nipple sparing mastectomy: an innovative skin incision for an alternative approach. Breast 17(1):8–11. https://doi.org/10.1016/j.breast.2007.07.040PubMedCrossRef

30.

Chung AP, Sacchini V (2008) Nipple-sparing mastectomy: where are we now? Surg Oncol 17(4):261–266PubMedCrossRef

Title: Evolution and time trends of nipple-sparing mastectomy: a single-center experience
Authors: Erika Barbieri
Federico Frusone
Alberto Bottini
Andrea Sagona
Wolfgang Gatzemeier
Giuseppe Canavese
Chiara Annunziata Pasqualina Anghelone
Alessandro De Luca
Emilia Marrazzo
Maria Ida Amabile
Corrado Tinterri
Publication date: 01-09-2020
Publisher: Springer International Publishing
Keywords: Breast Surgery
Mastectomy
Breast Surgery
Breast Cancer
Breast Cancer
Published in: Updates in Surgery / Issue 3/2020
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-020-00796-5

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Evolution and time trends of nipple-sparing mastectomy: a single-center experience

Abstract

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 3/2020

Should radical surgery for rectal cancer be offered to elderly population? A propensity-matching analysis on short- and long-term outcomes

Laparoscopic ileo-colic resection and right hemicolectomy for Crohn’s disease and colon cancer: a preliminary comparative study on post-operative outcome

Italian multi-society modified Delphi consensus on the definition and management of anastomotic leakage in colorectal surgery

The prognostic impact of neoadjuvant chemoradiotherapy on lymph node sampling in patients with locally advanced rectal cancer

Autologous peritoneal graft for venous vascular reconstruction after tumor resection in abdominal surgery: a systematic review

Is the outcome after hepatectomy for transitional hepatocholangiocarcinoma different from that of hepatocellular carcinoma and mass-forming cholangiocarcinoma? A case-matched analysis