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12-09-2023 | Mastectomy | Breast Oncology

Nipple-Sparing Mastectomies in Patients over the Age of 60 Years: Factors Associated with Surgical Outcomes

Authors: Nisha Parmeshwar, MD, Catherine L. Dugan, BS, Laura L. Barnes, MD, Justin K. Cheng, MD, Anne K. Patterson, BS, Amanda Miller, BS, Rita Mukhtar, MD, Merisa Piper, MD

Published in: Annals of Surgical Oncology | Issue 13/2023

Abstract

Background

Nipple-sparing mastectomy (NSM) outcomes in the elderly have not been well characterized. The goal of this study was to evaluate NSM outcomes in patients over age 60.

Patients and Methods

A single-institution retrospective cohort study was performed for NSM patients over the age of 60 from January 2004 to January 2022. Demographic, intraoperative, and postoperative variables were collected.

Results

We identified 136 women who underwent a total of 200 NSMs at a mean age 65.2 years and with mean body mass index of 25. Most (56%) had invasive breast cancer, requiring neoadjuvant chemotherapy in 15%, and 17.5% had radiation prior to NSM. A total of 91% had immediate tissue expander placement. The infection rate was 19%, with 11.5% requiring expander explantation in the follow-up period. In binomial logistic regression analysis, prior radiation increased the odds of any complication by 2.9 (OR 2.93, CI 1.30–6.58, p = 0.009) and increased the odds of infection by 5.7 (OR 5.70, CI 1.95–16.66, p = 0.001), but no associations were seen for other covariates including age, comorbidities, prior chemotherapy, or presence of invasive disease. Diabetes increased the odds of wound breakdown specifically by 9.0 (OR 8.97, CI 2.01–39.92, p = 0.004). Local recurrence was 3% in mean 3.4-year follow-up.

Conclusions

Our data support NSM in patients over the age of 60 years with acceptable outcomes within the standard of care. Locoregional recurrence was within the cited range of 0–5%, and only diabetes and prior radiation were associated with reconstructive complications. NSM should thus be offered when appropriate regardless of increased age to achieve oncologic and reconstructive goals.

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Title: Nipple-Sparing Mastectomies in Patients over the Age of 60 Years: Factors Associated with Surgical Outcomes
Authors: Nisha Parmeshwar, MD
Catherine L. Dugan, BS
Laura L. Barnes, MD
Justin K. Cheng, MD
Anne K. Patterson, BS
Amanda Miller, BS
Rita Mukhtar, MD
Merisa Piper, MD
Publication date: 12-09-2023
Publisher: Springer International Publishing
Keyword: Mastectomy
Published in: Annals of Surgical Oncology / Issue 13/2023
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-023-14278-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Nipple-Sparing Mastectomies in Patients over the Age of 60 Years: Factors Associated with Surgical Outcomes

Abstract

Background

Patients and Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Patients and Methods

Results

Conclusions

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