Nipple-sparing mastectomy with immediate breast reconstruction - early complications and outcomes of the treatment

Prz Menopauzalny. 2020 Sep;19(3):117-122. doi: 10.5114/pm.2020.99618. Epub 2020 Oct 2.

Abstract

Aim of the study: To assess the early complications and outcomes of the treatment of patients undergoing nipple-sparing mastectomy (NSM) with immediate breast reconstruction.

Material and methods: A retrospective study was performed on 120 patients who underwent 130 NSM (10 bilateral) procedures between 1.01.2015 and 31.12.2017 in two oncology centers in Poland. In 80 patients a breast cancer was recognized. Sixteen patients underwent operations on the basis of being carriers of the BRCA1 mutation. The follow-up period ranged from 10 to 34 months. The NSM procedures were performed with or without skin reduction and a free nipple-areola complex (NAC) transplant, with 130 prosthetic devices inserted subpectorally. Breast cancer patients followed the standard protocol for adjuvant therapy.

Results: The patients for risk-reducing mastectomies were younger. Prevalent histology was no special type (NST) in 60 out of 80 patients, mean tumor - NAC distance was 43.3 mm. The prevalent biological subtype was Luminal B HER2-negative. Adjuvant management consisted of chemotherapy in 61 and radiotherapy in 35 patients. We noted 14 cases of complications, 13 in the cancer group, and 1 in the non-cancer group. Skin necrosis was the most common. The mean time for the appearance of the complications was 2.8 months. No local recurrences were observed.

Conclusions: NSM is a safe and effective surgical option for qualified patients with breast cancer and in risk-reducing mastectomies.

Keywords: BRCA1; breast cancer; immediate breast reconstruction; subcutaneous mastectomy.