caa a22 4500 445333553 CHVBK 20180317142745.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1245/s10434-010-1475-4 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1475-4 Nipple-Sparing Mastectomy in 99 Patients With a Mean Follow-up of 5Years [Elektronische Daten] [J. Jensen, Jay Orringer, Armando Giuliano] Background: The safety and practicality of nipple-sparing mastectomy (NSM) are controversial. Methods: Review of a large breast center's experience identified 99 women who underwent intended NSM with subareolar biopsy and breast reconstruction for primary breast cancer. Outcome was assessed by biopsy status, postoperative nipple necrosis or removal, cancer recurrence, and cancer-specific death. Results: NSM was attempted for invasive cancer (64 breasts, 24 with positive lymph nodes), noninvasive cancer (35 breasts), and/or contralateral prophylaxis (50 breasts). Twenty-two nipples (14%) were removed because of positive subareolar biopsy results (frozen or permanent section). Seven patients underwent a pre-NSM surgical delay procedure because of increased risk for nipple necrosis. Reconstruction used transverse rectus abdominis myocutaneous flaps (56 breasts), latissimus flaps with expander (35 breasts), or expander alone (58 breasts). Of 127 retained nipples, 8 (6%) became necrotic and 2 others (2%) were removed at patient request. There was no nipple necrosis when NSM was performed after a surgical delay procedure. At a mean follow-up of 60.2months, all 3 patients with recurrence had biopsy-proven subareolar disease and had undergone nipple removal at original mastectomy. There were no deaths. Conclusions: Five-year recurrence rate is low when NSM margins (frozen section and permanent) are negative. Nipple necrosis can be minimized by incisions that maximize perfusion of surrounding skin and by avoiding long flaps. A premastectomy surgical delay procedure improves nipple survival in high-risk patients. NSM can be performed safely with all types of breast reconstruction. Society of Surgical Oncology, 2010 Jensen J. Department of Surgical Oncology, John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, CA, USA aut Orringer Jay Department of Surgical Oncology, John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, CA, USA aut Giuliano Armando Department of Surgical Oncology, John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, CA, USA aut Annals of Surgical Oncology Springer-Verlag 18/6(2011-06-01), 1665-1670 1068-9265 18:6<1665 2011 18 10434 https://doi.org/10.1245/s10434-010-1475-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1475-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Jensen J. Department of Surgical Oncology, John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, CA, USA aut NATIONALLICENCE 700 1- Orringer Jay Department of Surgical Oncology, John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, CA, USA aut NATIONALLICENCE 700 1- Giuliano Armando Department of Surgical Oncology, John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, CA, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/6(2011-06-01), 1665-1670 1068-9265 18:6<1665 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer