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Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
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Low Cancer Occurrence Rate following Prophylactic Nipple-Sparing Mastectomy
Carter J Boyd1, Sruthi Ramesh1, Jonathan M Bekisz1
1From the Hansjörg Wyss Department of Plastic Surgery.
Plastic and Reconstructive Surgery
|March 31, 2023
Summary
Prophylactic nipple-sparing mastectomy (NSM) is safe for breast cancer prevention, with very low rates of new cancer. Some patients may have cancer detected during prophylactic surgery, highlighting the need for ongoing surveillance.
Area of Science:
- Oncology
- Surgical Oncology
- Breast Surgery
Background:
- Nipple-sparing mastectomy (NSM) is increasingly utilized for breast cancer prophylaxis.
- Long-term oncologic safety data for prophylactic NSM are limited.
Purpose of the Study:
- To determine the incidence of breast cancer in patients who underwent prophylactic NSM.
- To evaluate the long-term oncologic outcomes following prophylactic NSM.
Main Methods:
- Retrospective review of patients undergoing prophylactic NSM from 2006-2019.
- Analysis of demographic factors, genetic predispositions, mastectomy pathology, and oncologic occurrences.
- Descriptive statistics to characterize patient and outcome data.
Main Results:
- 871 prophylactic NSMs performed on 641 patients with a median follow-up of 82 months.
- Cancer identified in 4.4% of mastectomy specimens, predominantly ductal carcinoma in situ.
- One patient (0.16%) developed breast cancer 6.5 years post-prophylactic mastectomy.
Conclusions:
- Prophylactic NSM demonstrates very low primary oncologic occurrence rates in high-risk patients.
- Prophylactic surgery can be therapeutic for a small subset of patients.
- Continued long-term surveillance is crucial for patients who have undergone prophylactic NSM.
