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Long-term outcomes of patients with breast cancer after nipple-sparing mastectomy/skin-sparing mastectomy followed by immediate transverse rectus abdominis musculocutaneous flap reconstruction: Comparison with conventional mastectomy in a single center study.

Abstract To evaluate the oncological outcomes of patients with breast cancer after nipple-sparing mastectomy (NSM)/skin-sparing mastectomy (SSM), followed by immediate reconstruction, as compared to conventional mastectomy (CM).SSM/NSM has been increasingly used to treat women with breast cancer who wish to preserve the overlying breast skin, but concern exist regarding its oncological safety due to the potential for residual breast tissue. We report our experience performing SSM/NSM for breast cancer treatment compared to CM with a long follow-up period.All consecutive patients who underwent mastectomy for breast cancer at Asan Medical Center between January 1993 and December 2008 were identified by retrospective medical chart review. The patients who underwent NSM/SSM, followed by immediate breast reconstruction with a pedicled transverse rectus abdominis musculocutaneous flap (TRAM), were compared to the patients who underwent CM in terms of breast-cancer specific survival (BCSS) rate, distant metastasis-free survival (DMFS) rate, and local recurrence (LR) rate.During the study period, 6028 patients underwent mastectomy for breast cancer. Of these, 1032 and 4996 underwent NSM/SSM with TRAM and CM, respectively. Their median follow-up durations were 94.4 (range, 8.1-220.2) and 110.8 (range, 6.1-262.0) months, respectively. Their 5 year BCSS rates were 95.4% and 88.1%, respectively (log-rank, P < .001). Their 5 year DMFS rates were 93.0% and 85.6%, respectively (log-rank, P < .001).Relative to CM, NSM/SSM, followed by immediate breast reconstruction, may be a viable and oncologically safe surgical treatment in selected patients with breast cancer.
PMID
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Authors

Mayor MeshTerms

Breast Neoplasms

Mastectomy

Neoplasm Recurrence, Local

Nipples

Keywords
Journal Title medicine
Publication Year Start




PMID- 29718895
OWN - NLM
STAT- MEDLINE
DCOM- 20180509
LR  - 20180509
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 18
DP  - 2018 May
TI  - Long-term outcomes of patients with breast cancer after nipple-sparing
      mastectomy/skin-sparing mastectomy followed by immediate transverse rectus
      abdominis musculocutaneous flap reconstruction: Comparison with conventional
      mastectomy in a single center study.
PG  - e0680
LID - 10.1097/MD.0000000000010680 [doi]
AB  - To evaluate the oncological outcomes of patients with breast cancer after
      nipple-sparing mastectomy (NSM)/skin-sparing mastectomy (SSM), followed by
      immediate reconstruction, as compared to conventional mastectomy (CM).SSM/NSM has
      been increasingly used to treat women with breast cancer who wish to preserve the
      overlying breast skin, but concern exist regarding its oncological safety due to 
      the potential for residual breast tissue. We report our experience performing
      SSM/NSM for breast cancer treatment compared to CM with a long follow-up
      period.All consecutive patients who underwent mastectomy for breast cancer at
      Asan Medical Center between January 1993 and December 2008 were identified by
      retrospective medical chart review. The patients who underwent NSM/SSM, followed 
      by immediate breast reconstruction with a pedicled transverse rectus abdominis
      musculocutaneous flap (TRAM), were compared to the patients who underwent CM in
      terms of breast-cancer specific survival (BCSS) rate, distant metastasis-free
      survival (DMFS) rate, and local recurrence (LR) rate.During the study period,
      6028 patients underwent mastectomy for breast cancer. Of these, 1032 and 4996
      underwent NSM/SSM with TRAM and CM, respectively. Their median follow-up
      durations were 94.4 (range, 8.1-220.2) and 110.8 (range, 6.1-262.0) months,
      respectively. Their 5 year BCSS rates were 95.4% and 88.1%, respectively
      (log-rank, P &lt; .001). Their 5 year DMFS rates were 93.0% and 85.6%, respectively 
      (log-rank, P &lt; .001).Relative to CM, NSM/SSM, followed by immediate breast
      reconstruction, may be a viable and oncologically safe surgical treatment in
      selected patients with breast cancer.
FAU - Lee, Sae Byul
AU  - Lee SB
AD  - Division of Breast and Endocrine Surgery, Department of Surgery.
FAU - Lee, Jong Won
AU  - Lee JW
AD  - Division of Breast and Endocrine Surgery, Department of Surgery.
FAU - Kim, Hee Jeong
AU  - Kim HJ
AD  - Division of Breast and Endocrine Surgery, Department of Surgery.
FAU - Ko, Beom Seok
AU  - Ko BS
AD  - Division of Breast and Endocrine Surgery, Department of Surgery.
FAU - Son, Byung Ho
AU  - Son BH
AD  - Division of Breast and Endocrine Surgery, Department of Surgery.
FAU - Eom, Jin Sup
AU  - Eom JS
AD  - Department of Plastic Surgery, Asan Medical Center, University of Ulsan College
      of Medicine, Seoul.
FAU - Lee, Taik Jong
AU  - Lee TJ
AD  - Department of Plastic Surgery, Boryeong Asan Medical Center, Boryeong, Korea.
FAU - Ahn, Sei-Hyun
AU  - Ahn SH
AD  - Division of Breast and Endocrine Surgery, Department of Surgery.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - *Breast Neoplasms/epidemiology/pathology/surgery
MH  - Female
MH  - Humans
MH  - Long Term Adverse Effects/epidemiology/prevention &amp; control
MH  - Mammaplasty/*methods
MH  - *Mastectomy/adverse effects/methods
MH  - Middle Aged
MH  - Myocutaneous Flap
MH  - *Neoplasm Recurrence, Local/epidemiology/prevention &amp; control
MH  - Neoplasm Staging
MH  - *Nipples/pathology/surgery
MH  - Organ Sparing Treatments/methods
MH  - Outcome and Process Assessment (Health Care)
MH  - Rectus Abdominis/surgery
MH  - Republic of Korea/epidemiology
MH  - Retrospective Studies
MH  - Tumor Burden
EDAT- 2018/05/03 06:00
MHDA- 2018/05/10 06:00
CRDT- 2018/05/03 06:00
PHST- 2018/05/03 06:00 [entrez]
PHST- 2018/05/03 06:00 [pubmed]
PHST- 2018/05/10 06:00 [medline]
AID - 10.1097/MD.0000000000010680 [doi]
AID - 00005792-201805040-00063 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 May;97(18):e0680. doi: 10.1097/MD.0000000000010680.