Oncologic safety of nipple skin-sparing or total skin-sparing mastectomies with immediate reconstruction

Cristiano Boneti, James Yuen, Carlos Santiago, Zuleika Diaz, Yara Robertson, Soheila Korourian, Kent C. Westbrook, Ronda S. Henry-Tillman, Vicki Klimberg

Research output: Contribution to journalArticle

108 Citations (Scopus)

Abstract

Background: Success with skin-sparing mastectomy (SSM) has led to the reconsideration of the necessity to remove the skin overlying the nipple-areola complex. The aim of our study was to compare complications and local recurrence in patients undergoing SSM and total skin-sparing mastectomy (TSSM) with immediate reconstruction. Methods: This IRB-approved retrospective study involved patients who underwent mastectomy with reconstruction (1998 to 2010). Patient demographics, tumor characteristics, type of surgery, cosmesis, postoperative complications, and recurrence were analyzed. Results: The 293 patients in our study group had a total of 508 procedures: 281 TSSMs and 227 SSMs, distributed among 215 patients with bilateral procedures and 78 with unilateral operations. Mean age was 51.2 ± 10.9 years for TSSM and 53.1 ± 11.5 years for SSM. The average tumor size was 1.9 ± 1.6 cm for TSSM versus 2.1 ± 1.7 cm for the SSM group. The overall complication rate (TSSM 7.1% [20 of 281] and SSM 6.2% [14 of 227], p = 0.67) and local-regional recurrence rate (TSSM 6% [7 of 152] and SSM 5.0% [7 of 141], p = 0.89) were comparable. The TSSM rating was significantly higher (score 9.2 ± 1.1) than the SSM group (score 8.3 ± 1.9, p = 0.04). Conclusion: TSSM appears to be oncologically safe with superior cosmesis, affords one-step immediate reconstruction, and can be offered to patients with stages I and II breast cancer and those who have been down-staged with neoadjuvant chemotherapy.

Original languageEnglish (US)
Pages (from-to)686-693
Number of pages8
JournalJournal of the American College of Surgeons
Volume212
Issue number4
DOIs
StatePublished - Apr 2011
Externally publishedYes

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Nipples
Mastectomy
Safety
Skin
Recurrence
Simple Mastectomy
Research Ethics Committees

ASJC Scopus subject areas

  • Surgery

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Oncologic safety of nipple skin-sparing or total skin-sparing mastectomies with immediate reconstruction. / Boneti, Cristiano; Yuen, James; Santiago, Carlos; Diaz, Zuleika; Robertson, Yara; Korourian, Soheila; Westbrook, Kent C.; Henry-Tillman, Ronda S.; Klimberg, Vicki.

In: Journal of the American College of Surgeons, Vol. 212, No. 4, 04.2011, p. 686-693.

Research output: Contribution to journalArticle

Boneti, C, Yuen, J, Santiago, C, Diaz, Z, Robertson, Y, Korourian, S, Westbrook, KC, Henry-Tillman, RS & Klimberg, V 2011, 'Oncologic safety of nipple skin-sparing or total skin-sparing mastectomies with immediate reconstruction', Journal of the American College of Surgeons, vol. 212, no. 4, pp. 686-693. https://doi.org/10.1016/j.jamcollsurg.2010.12.039
Boneti, Cristiano ; Yuen, James ; Santiago, Carlos ; Diaz, Zuleika ; Robertson, Yara ; Korourian, Soheila ; Westbrook, Kent C. ; Henry-Tillman, Ronda S. ; Klimberg, Vicki. / Oncologic safety of nipple skin-sparing or total skin-sparing mastectomies with immediate reconstruction. In: Journal of the American College of Surgeons. 2011 ; Vol. 212, No. 4. pp. 686-693.
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abstract = "Background: Success with skin-sparing mastectomy (SSM) has led to the reconsideration of the necessity to remove the skin overlying the nipple-areola complex. The aim of our study was to compare complications and local recurrence in patients undergoing SSM and total skin-sparing mastectomy (TSSM) with immediate reconstruction. Methods: This IRB-approved retrospective study involved patients who underwent mastectomy with reconstruction (1998 to 2010). Patient demographics, tumor characteristics, type of surgery, cosmesis, postoperative complications, and recurrence were analyzed. Results: The 293 patients in our study group had a total of 508 procedures: 281 TSSMs and 227 SSMs, distributed among 215 patients with bilateral procedures and 78 with unilateral operations. Mean age was 51.2 ± 10.9 years for TSSM and 53.1 ± 11.5 years for SSM. The average tumor size was 1.9 ± 1.6 cm for TSSM versus 2.1 ± 1.7 cm for the SSM group. The overall complication rate (TSSM 7.1{\%} [20 of 281] and SSM 6.2{\%} [14 of 227], p = 0.67) and local-regional recurrence rate (TSSM 6{\%} [7 of 152] and SSM 5.0{\%} [7 of 141], p = 0.89) were comparable. The TSSM rating was significantly higher (score 9.2 ± 1.1) than the SSM group (score 8.3 ± 1.9, p = 0.04). Conclusion: TSSM appears to be oncologically safe with superior cosmesis, affords one-step immediate reconstruction, and can be offered to patients with stages I and II breast cancer and those who have been down-staged with neoadjuvant chemotherapy.",
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AU - Boneti, Cristiano

AU - Yuen, James

AU - Santiago, Carlos

AU - Diaz, Zuleika

AU - Robertson, Yara

AU - Korourian, Soheila

AU - Westbrook, Kent C.

AU - Henry-Tillman, Ronda S.

AU - Klimberg, Vicki

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N2 - Background: Success with skin-sparing mastectomy (SSM) has led to the reconsideration of the necessity to remove the skin overlying the nipple-areola complex. The aim of our study was to compare complications and local recurrence in patients undergoing SSM and total skin-sparing mastectomy (TSSM) with immediate reconstruction. Methods: This IRB-approved retrospective study involved patients who underwent mastectomy with reconstruction (1998 to 2010). Patient demographics, tumor characteristics, type of surgery, cosmesis, postoperative complications, and recurrence were analyzed. Results: The 293 patients in our study group had a total of 508 procedures: 281 TSSMs and 227 SSMs, distributed among 215 patients with bilateral procedures and 78 with unilateral operations. Mean age was 51.2 ± 10.9 years for TSSM and 53.1 ± 11.5 years for SSM. The average tumor size was 1.9 ± 1.6 cm for TSSM versus 2.1 ± 1.7 cm for the SSM group. The overall complication rate (TSSM 7.1% [20 of 281] and SSM 6.2% [14 of 227], p = 0.67) and local-regional recurrence rate (TSSM 6% [7 of 152] and SSM 5.0% [7 of 141], p = 0.89) were comparable. The TSSM rating was significantly higher (score 9.2 ± 1.1) than the SSM group (score 8.3 ± 1.9, p = 0.04). Conclusion: TSSM appears to be oncologically safe with superior cosmesis, affords one-step immediate reconstruction, and can be offered to patients with stages I and II breast cancer and those who have been down-staged with neoadjuvant chemotherapy.

AB - Background: Success with skin-sparing mastectomy (SSM) has led to the reconsideration of the necessity to remove the skin overlying the nipple-areola complex. The aim of our study was to compare complications and local recurrence in patients undergoing SSM and total skin-sparing mastectomy (TSSM) with immediate reconstruction. Methods: This IRB-approved retrospective study involved patients who underwent mastectomy with reconstruction (1998 to 2010). Patient demographics, tumor characteristics, type of surgery, cosmesis, postoperative complications, and recurrence were analyzed. Results: The 293 patients in our study group had a total of 508 procedures: 281 TSSMs and 227 SSMs, distributed among 215 patients with bilateral procedures and 78 with unilateral operations. Mean age was 51.2 ± 10.9 years for TSSM and 53.1 ± 11.5 years for SSM. The average tumor size was 1.9 ± 1.6 cm for TSSM versus 2.1 ± 1.7 cm for the SSM group. The overall complication rate (TSSM 7.1% [20 of 281] and SSM 6.2% [14 of 227], p = 0.67) and local-regional recurrence rate (TSSM 6% [7 of 152] and SSM 5.0% [7 of 141], p = 0.89) were comparable. The TSSM rating was significantly higher (score 9.2 ± 1.1) than the SSM group (score 8.3 ± 1.9, p = 0.04). Conclusion: TSSM appears to be oncologically safe with superior cosmesis, affords one-step immediate reconstruction, and can be offered to patients with stages I and II breast cancer and those who have been down-staged with neoadjuvant chemotherapy.

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