Long-Term Cancer Recurrence Rates Following Nipple-Sparing Mastectomy: A 10-Year Follow Up Study
Jonathan M. Bekisz, MD, MSci, Carter J. Boyd, MD, MBA, Ara A. Salibian, MD, Nolan S. Karp, MD, Mihye Choi, MD.
New York University Langone Health, New York, NY, USA.
PURPOSE: Although nipple-sparing mastectomy (NSM) is a widely accepted and popular technique, limited data exists examining long-term cancer recurrence rates associated with it. This study sought to analyze rates of breast cancer recurrence in patients who underwent therapeutic NSM with a median of 10 years of follow-up.
METHODS: A single institution retrospective review identified all patients who underwent NSM with a median of 10-years of follow-up. Analysis focused on patient demographics, mastectomy specimen pathology, and oncologic outcomes including cancer recurrence. Independent risk factors for locoregional recurrence were assessed via univariate logistic regression.
RESULTS: 158 therapeutic NSMs were performed on 152 patients. Invasive ductal carcinoma (48.7%) and ductal carcinoma in situ (35.4%) were the most common tumor types seen on pathology. Multifocal/multicentric disease and lymphovascular invasion were present in 34.1% and 12.8% of specimens, respectively. Sentinel lymph node biopsy rate was 82.9%, with 15.2% reported as positive. Rates of positive frozen and permanent subareolar biopsy were 5.4% and 8.3%, respectively. Low cancer stages were overwhelmingly more common, with stage I and stage 0 representing 40.5% and 35.4% of the population, respectively. Incidence of recurrent disease was 3.2% per mastectomy and 3.3% per patient. Univariate analysis did not identify any variables that were independent risk factors for locoregional recurrence.
CONCLUSION: At a median of 10 years of follow-up, overall cancer recurrence rates are low in patients who undergo NSM, further suggesting the safety of this technique. Regardless, close surveillance should remain a goal to ensure prompt detection of any sign of recurrence.
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