caa a22 4500 445339160 CHVBK 20180317142806.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1245/s10434-011-1974-y doi (NATIONALLICENCE)springer-10.1245/s10434-011-1974-y Nipple-Sparing Mastectomy for Breast Cancer and Risk-Reducing Surgery: The Memorial Sloan-Kettering Cancer Center Experience [Elektronische Daten] [Paulo de Alcantara Filho, Deborah Capko, John Barry, Monica Morrow, Andrea Pusic, Virgilio Sacchini] Background: Nipple-sparing mastectomy (NSM) has been gathering increased recognition as an alternative to more traditional mastectomy approaches. Initially, questions concerning its oncologic safety limited the use of NSM. Nevertheless, mounting evidence supporting the practice of NSM for both prophylactic and oncologic purposes is leading to its more widespread use and broadened indications. Methods: Using a prospectively maintained database, we reviewed our experience of 353 NSM procedures performed in 200 patients over the past 10years. Results: The indications for surgery were: 196 prophylactic risk-reduction (55.5%), 74 ductal carcinoma in situ (DCIS) (20.8%), 82 invasive cancer (23.2%), and 1 phyllodes tumor (0.5%). The nipple areolar complex (NAC) was entirely preserved in 341 mastectomies (96.7%). There were 11 patients (3.1%) who were found to have cancer at the nipple margin, warranting further excision. A total of 69 breasts (19.5%) had some degree of skin desquamation or necrosis, but only 12 (3.3%) required operative debridement, of which 3 breasts (1%) necessitated removal of a breast implant. Also, 6 patients (2%) were treated for infection. Of the 196 prophylactic NSMs, 11 specimens (5.6%) were found to harbor occult cancer (8 DCIS and 3 invasive cancers). One patient who underwent NSM for invasive ductal carcinoma in 2006 developed metastatic disease to her brain. No other recurrences are attributable to the 353 NSMs. Conclusions: The trends demonstrate the increasing acceptance of NSM as a prophylactic procedure as well as for therapeutic purposes. Although NSM is not standard, our experience supports the selective use of NSM in both prophylactic and malignant settings. Society of Surgical Oncology, 2011 de Alcantara Filho Paulo Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Capko Deborah Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Barry John Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Morrow Monica Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Pusic Andrea Plastic and Reconstruction Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Sacchini Virgilio Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Annals of Surgical Oncology Springer-Verlag 18/11(2011-10-01), 3117-3122 1068-9265 18:11<3117 2011 18 10434 https://doi.org/10.1245/s10434-011-1974-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1974-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- de Alcantara Filho Paulo Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Capko Deborah Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Barry John Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Morrow Monica Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Pusic Andrea Plastic and Reconstruction Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Sacchini Virgilio Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/11(2011-10-01), 3117-3122 1068-9265 18:11<3117 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer