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Related Experiment Video

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Minimal Access vs Conventional Nipple-Sparing Mastectomy.

Joo Heung Kim1, Jai Min Ryu2, Soong June Bae3

  • 1Department of Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.

JAMA Surgery
|August 14, 2024
PubMed
Summary

Minimal access nipple-sparing mastectomy (M-NSM) and conventional nipple-sparing mastectomy (C-NSM) show similar complication rates. Both surgical approaches are equally safe, with choices guided by patient needs and preferences.

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Area of Science:

  • Surgical Oncology
  • Breast Cancer Surgery
  • Minimally Invasive Surgery

Background:

  • Nipple-sparing mastectomy (NSM) is increasingly performed using minimally invasive techniques (M-NSM) alongside conventional methods (C-NSM).
  • Limited comparative data exists on postoperative complications between M-NSM and C-NSM.

Purpose of the Study:

  • To compare the incidence of postoperative complications in patients undergoing M-NSM versus C-NSM for breast cancer.

Main Methods:

  • Retrospective multicenter cohort study of 1583 female patients with breast cancer undergoing NSM.
  • Exclusion criteria included malignancy in the nipple-areolar complex (NAC), inflammatory breast cancer, and advanced disease.
  • Data on clinicopathological factors and complications within 3 months post-surgery were analyzed using logistic regression.

Main Results:

  • Overall short- (<30 days) and long-term (<90 days) complication rates were similar between M-NSM (32.16%, 32.16%) and C-NSM (34.29%, 38.72%).
  • Nipple-areolar complex necrosis was less frequent after M-NSM (2.20%) compared to C-NSM (6.71%) (P=.04).
  • Wound infection was higher after M-NSM (7.93% vs 4.28%), while seroma was higher after C-NSM (14.23% vs 9.25%).

Conclusions:

  • M-NSM and C-NSM demonstrate comparable safety profiles regarding overall postoperative complications.
  • Factors like breast ptosis and incision type influence necrosis risk.
  • The choice between M-NSM and C-NSM can be individualized based on patient preferences and specific surgical considerations.