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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2019

01-05-2019 | Mastectomy | Breast Oncology

Prospective Evaluation of Residual Breast Tissue After Skin- or Nipple-Sparing Mastectomy: Results of the SKINI-Trial

Authors: Bärbel Papassotiropoulos, MD, Uwe Güth, MD, Federica Chiesa, MD, Christoph Rageth, MD, Esther Amann, MD, Astrid Baege, MD, Constanze Elfgen, MD, Zsuzsanna Varga, MD, Linda Moskovszky, MD, Katharina Endhardt, MD, Regina Masser, MD, Marianne Tinguely, MD, Jian Farhadi, MD, Alessia Lardi, MD, Florian Dammann, MD, Joachim Diebold, MD, Qiyu Li, MSc, Peter Dubsky, MD, Christoph Tausch, MD

Published in: Annals of Surgical Oncology | Issue 5/2019

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Objective

This study was designed to investigate the presence of residual breast tissue (RBT) after skin-sparing mastectomy (SSM) and nipple-sparing mastectomy (NSM) and to analyse patient- and therapy-related factors associated with RBT. Skin-sparing mastectomy and NSM are increasingly used surgical procedures. Prospective data on the completeness of breast tissue resection is lacking. However, such data are crucial for assessing oncologic safety of risk-reducing and curative mastectomies.

Methods

Between April 2016 and August 2017, 99 SSM and 61 NSM were performed according to the SKINI-trial protocol, under either curative (n = 109) or risk-reducing (n = 51) indication. After breast removal, biopsies from the skin envelope (10 biopsies per SSM, 14 biopsies per NSM) were taken in predefined radial localizations and assessed histologically for the presence of RBT and of residual disease.

Results

Residual breast tissue was detected in 82 (51.3%) mastectomies. The median RBT percentage per breast was 7.1%. Of all factors considered, only type of surgery (40.4% for SSM vs. 68.9% for NSM; P < 0.001) and surgeon (P < 0.001) were significantly associated with RBT. None of the remaining factors, e.g., skin flap necrosis, was associated significantly with RBT. Residual disease was detected in three biopsies.

Conclusions

Residual breast tissue is commonly observed after SSM and NSM. In contrast, invasive or in situ carcinomas are rarely found in the skin envelope. Radicality of mastectomy in this trial is not associated with increased incidence of skin flap necrosis.
ClinicalTrials.gov Identifier NCT03470909.
Appendix
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Metadata
Title
Prospective Evaluation of Residual Breast Tissue After Skin- or Nipple-Sparing Mastectomy: Results of the SKINI-Trial
Authors
Bärbel Papassotiropoulos, MD
Uwe Güth, MD
Federica Chiesa, MD
Christoph Rageth, MD
Esther Amann, MD
Astrid Baege, MD
Constanze Elfgen, MD
Zsuzsanna Varga, MD
Linda Moskovszky, MD
Katharina Endhardt, MD
Regina Masser, MD
Marianne Tinguely, MD
Jian Farhadi, MD
Alessia Lardi, MD
Florian Dammann, MD
Joachim Diebold, MD
Qiyu Li, MSc
Peter Dubsky, MD
Christoph Tausch, MD
Publication date
01-05-2019
Publisher
Springer International Publishing
Keyword
Mastectomy
Published in
Annals of Surgical Oncology / Issue 5/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-07259-1

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