publication date: Aug. 3, 2017

Breast Cancer

Nipple-sparing mastectomy has low rate of breast cancer recurrence

Findings in a single-center study show women with breast cancer who undergo nipple-sparing mastectomy have a low rate of the cancer returning within the first five years, when most recurrences in the breast are diagnosed.

The new study, published as an “article in press” on the Journal of the American College of Surgeons website, found an overall 5.5 percent recurrence rate among 311 operations at a median follow-up of 51 months, with no recurrence involving the retained nipple.

NSM removes the breast tissue, but leaves intact the breast skin, nipple, and areola, where a standard mastectomy removes the whole breast and breast skin, including the nipple.

Some physicians have reservations about the oncologic safety of nipple preservation because of lack of long-term follow-up, said principal investigator Barbara Smith, director of the Breast Program at Massachusetts General Hospital, Boston, where the study took place.

Their recurrence rate, she said, is comparable to reported rates of disease recurrence after standard mastectomy. Furthermore, the procedure has several advantages over standard mastectomy.

Smith credited their success with NSM to advances in breast cancer treatment, her team’s study of breast anatomy, and their surgical techniques. Earlier European approaches to NSM typically left some breast tissue under the nipple and then applied radiation to the nipple during the operation, she said.

However, she said her team and most U.S. surgeons thoroughly remove the breast tissue under the “envelope” of breast skin and nipple because they believe that recurrence rates will be lower using this technique. They then remove and test the breast tissue under the nipple. If the biopsy result shows cancer, the surgeon later removes the nipple in an outpatient procedure.

Breast tissue could … Continue reading CCL July 2017 – Nipple-sparing mastectomy has low rate of breast cancer recurrence

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