The Oncologic Safety of Skin Sparing Mastectomy with or without Conservation of the Nipple-areolar Complex: 5 Years Follow up Results
- The Oncologic Safety of Skin Sparing Mastectomy with or without Conservation of the Nipple-areolar Complex: 5 Years Follow up Results
- 이수정; 강수환; 배영경; 전영산[전영산]
- IMMEDIATE BREAST RECONSTRUCTION; SUBCUTANEOUS MASTECTOMY; NEOPLASTIC INVOLVEMENT; CANCER; RECURRENCE; CARCINOMA; RISK; SERIES; FLAP
- Issue Date
- KOREAN BREAST CANCER SOC
- JOURNAL OF BREAST CANCER, v.13, no.1, pp.65 - 73
- Purpose: Little is known about long term results of nippleareola preserving skin-sparing mastectomy (NASSM), and there are no such reports on this from South Korea We studied 5 years follow up results of NASSM and skin sparing mastectomy (SSM) and compared clinical outcomes between NASSM and SSM Methods. Two hundred two patients who underwent SSM (69 patients) or NASSM (133 patients) from September 1996 to December 2006 were included. Frozen section analysis of retroareolar resection margin was done to make the decision on preserving or not preserving nippleareolar complex (NAC). In the case of positive result on the frozen section, NAC was sacrificed The local relapse (LR) rate and local relapse free survival (LFS) were analyzed for comparing between NASSM and SSM. Results: The mean age was 40 2 years (range, 24-65), the mean follow-up was 67.6 months. 52 NACs (25 7%) were involved by tumor cells. The invasion to the NAC by tumor cell was more common for invasive carcinoma with extensive intraductal component (p<0.001), central located tumor (p=0.025) and invasive carcinoma with multiplicity (p=0.001). There were 12 cases (9 0%) of local relapse in NASSM group and 4 (5 8%) in SSM group. but there was no significant correlation for the LR rate (p>0.05). Regional or distant recurrence after surgical treatment for local relapse occurred in only one SSM case Five years LFS rate of the NASSM group was 92.1% and that of the SSM group was 95.2%. There was no significant difference for the LFS (p>0.05). Conclusion: Our long term follow up study showed that NASSM and SSM are much alike for their LR rate and LFS. Even if relapse occurs in the NAC, this recurrence cannot affect the progression of relapse after adequate local treatment. Thus, NASSM is alternative method for SSM with oncological safety and better cosmetic outcome.
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