You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.


Advertisement

ABOUT ARCHIVES
Advanced Search

Welcome   | My Account | E-mail Alerts | RSS | Access Rights | Sign In


  Vol. 143 No. 11, November 2008 TABLE OF CONTENTS
  Online Only
 •  Online First Table of
Contents
  Original Article
 •Online Features
 This Article
 •Full text
 •PDF
 • Reply to article
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Citing articles on Web of Science (24)
 •Contact me when this article is cited
 Related Content
 •Related article
 •Similar articles in this journal
 Topic Collections
 •Oncology
 •Breast Cancer
 •Surgery
 •Surgical Interventions
 •Surgical Oncology
 •Women's Health
 •Women's Health, Other
 •Prognosis/ Outcomes
 •Alert me on articles by topic
 Social Bookmarking
  Add to CiteULike Add to Connotea Add to Delicious Add to Digg Add to Facebook Add to Reddit Add to Technorati Add to Twitter What's this?

Nipple-Sparing Mastectomy Update

One Hundred Forty-Nine Procedures and Clinical Outcomes

Joseph P. Crowe, MD; Rebecca J. Patrick, MA; Randall J. Yetman, MD; Risal Djohan, MD

Arch Surg. 2008;143(11):1106-1110.

Objectives  To describe our experience with patients who underwent the nipple-sparing mastectomy procedure developed and standardized at our institution and to report clinical outcomes for those patients with a breast cancer diagnosis.

Design  Prospective study for consecutive nipple-sparing mastectomy procedures.

Setting  Multidisciplinary breast center at a large tertiary care facility.

Patients  One hundred ten consecutive patients underwent nipple-sparing mastectomy between July 2001 and June 2007.

Intervention  Nipple-sparing mastectomy was offered to carefully screened patients; the nipple-areola tissue was cored and sent for histologic frozen-section analysis intraoperatively.

Main Outcome Measures  Assessment of nipple-areola cored tissue for neoplastic involvement; postoperative stability of retained nipple-areola complex; and clinical outcomes.

Results  Data were available for 149 nipple-sparing mastectomies performed on 110 patients. No procedure performed for prevention had neoplastic involvement of the cored nipple-areola tissue, while 9 procedures performed for breast cancer treatment were found to have neoplastic involvement. Postoperatively, 2 patients had partial loss of the nipple-areola complex due to sloughing and a third patient developed an infection that required surgical removal of the nipple-areola complex. Among patients with breast cancer, none with ductal carcinoma in situ has developed a recurrence, while 4 patients with infiltrating breast cancer have, including 2 patients with distant metastases only, a third with a chest wall recurrence, and a fourth with an axillary recurrence.

Conclusion  A low incidence of neoplastic involvement of the nipple-areola cored tissue leads to successful completion of nipple-sparing mastectomy for most patients.


Author Affiliations: Departments of General Surgery–Breast Center (Dr Crowe and Ms Patrick) and Plastic Surgery (Drs Yetman and Djohan), Cleveland Clinic, Cleveland, Ohio.



Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Delicious Delicious   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter     What's this?

RELATED ARTICLE

Nipple-Sparing Mastectomy Update—Invited Critique
Lisa K. Jacobs and Anna M. Voltura
Arch Surg. 2008;143(11):1110.
EXTRACT | FULL TEXT  


THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Nipple Involvement in Breast Cancer: Retrospective Analysis of 2323 Consecutive Mastectomy Specimens
Weidong Li et al.
INT J SURG PATHOL 2011;19:328-334.
ABSTRACT  

Advances in Nipple-Sparing Mastectomy: Oncological Safety and Incision Selection
Maxwell et al.
Aesthetic Surgery Journal 2011;31:310-319.
ABSTRACT | FULL TEXT  

The Impact of Surgery on Ductal Carcinoma In Situ Outcomes: The Use of Mastectomy
Hwang
J Natl Cancer Inst Monogr 2010;2010:197-199.
ABSTRACT | FULL TEXT  

Occult Nipple Involvement in Breast Cancer: Clinicopathologic Findings in 316 Consecutive Mastectomy Specimens
Brachtel et al.
JCO 2009;27:4948-4954.
ABSTRACT | FULL TEXT  





HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | PHYSICIAN JOBS | SUBMIT | SUBSCRIBE | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 2008 American Medical Association. All Rights Reserved.