Is Nipple-Sparing Mastectomy without Radiotherapy an Acceptable Alternative to Mastectomy in Patients with Early Breast Cancer from Oncological Perspectives?

Teruhisa Sakurai and Takeo Sakurai

Department of Surgery, Wakayama Medical University Kihoku Hospital, Wakayama, Japan
Department of Surgery, Sakurai Breast Clinic, Japan

^*Correspondance to: Teruhisa Sakurai 

 PDF  Full Text DOI: 10.25107/2474-1647.1457

Abstract

Nipple-Sparing Mastectomy (NSM) has evolved as an alternative surgical procedure that improves quality of life, including achieving good cosmetic outcomes, in women with breast cancer. We started to perform NSM on patients requiring mastectomy in 1978 with the aim of optimizing cosmetic outcomes. A preliminary investigation established the following early criteria for NSM: T0–T1 (≤2 cm), N0 (no clinical lymph node metastases), and shortest areola–tumor distance >3 cm. Early results were excellent. Our final inclusion criteria for NSM are macroscopic and radiographic intactness of the nipple areola complex. We retrospectively analyzed 723 patients with early stage breast cancer who had undergone NSM from 1985 to 2007, including 93 patients with and 630 without reconstructions. The cohort included 100 patients who had undergone NSM with Modified Radical Mastectomy (MRM) and 259 NSM with Breast Conserving Surgery (BCS) cases. No patients in the NSM and MRM groups received radiotherapy. We compared the Local Recurrence Rate (LRR), Disease-Free Survival (DFS) and Overall Survival (OS) between the NSM, MRM, and BCS groups. There were no significant differences in LRR, DFS, or OS between the NSM, MRM, and BCS groups. There were also no significant differences in LRR, DFS, or OS between patients who had undergone NSM with and without reconstructions. Therefore, we suggest that NSM without radiotherapy is a potential alternative to MRM and BCS in patients with early stage breast cancer from oncological perspectives.

Keywords

Nipple-sparing mastectomy; NSM;Mastectomy;Radiotherapy

Cite the article

Sakurai T, Sakurai T. Is Nipple-Sparing Mastectomy without Radiotherapy an Acceptable Alternative to Mastectomy in Patients with Early Breast Cancer from Oncological Perspectives? Clin Surg. 2017; 2: 1457.