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Residual Breast Tissue After Four Types of Mastectomy: A Prospective, Comparative Study
Marcin Jakub Napierała1, Wojciech Olszewski2, Magdalena Rosińska3
1Department of Breast Cancer and Reconstructive Surgery, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland. mj.napierala@gmail.com.
Annals of Surgical Oncology
|April 24, 2025
Summary
Residual breast tissue (RBT) is common after mastectomy, regardless of the surgical approach. Prior surgeries increase RBT risk, while experienced surgeons may reduce it, especially in nipple-sparing mastectomy.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- Residual breast tissue (RBT) after mastectomy raises oncologic safety concerns.
- Limited data exists on RBT prevalence and clinical significance due to small sample sizes and inconsistent methods.
- This study addresses RBT prevalence across four mastectomy types and identifies influencing factors.
Purpose of the Study:
- To evaluate the prevalence of residual breast tissue (RBT) in patients undergoing different types of mastectomy.
- To identify factors associated with the presence of RBT, including mastectomy type, breast size, prior surgeries, and surgeon experience.
Main Methods:
- A prospective study involving 350 patients and 403 mastectomies.
- Systematic tissue sampling from standardized locations beneath skin flaps and the nipple-areolar complex (NAC) for nipple-sparing mastectomy (NSM).
- Assessment of RBT prevalence and correlation with clinical and surgical variables.
Main Results:
- Residual breast tissue (RBT) was found in 34.2% of all cases, with no significant difference across simple mastectomy (SM), modified radical mastectomy (MRM), and skin-sparing mastectomy (SSM).
- RBT was present in 93% of cases under the NAC in nipple-sparing mastectomy (NSM).
- Larger breast size correlated with lower RBT prevalence, while prior surgeries significantly increased RBT occurrence (p=0.03). Surgeon experience (≥50 mastectomies/year) was associated with reduced RBT rates in NSM.
Conclusions:
- Residual breast tissue is a frequent finding irrespective of mastectomy type, necessitating standardized evaluation and further research into clinical implications.
- Optimizing mastectomy techniques and leveraging experienced surgeons may mitigate RBT risk.
- This study provides foundational insights for improving mastectomy procedures and patient outcomes.
