Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA.
Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA.
J Am Coll Surg. 2017 Sep;225(3):361-365. doi: 10.1016/j.jamcollsurg.2017.06.013. Epub 2017 Jul 17.
Nipple-sparing mastectomy (NSM) has gained popularity for breast cancer treatment and prevention. There are limited data about long-term oncologic safety of this procedure.
We reviewed oncologic outcomes of consecutive therapeutic NSM at a single institution. Nipple-sparing mastectomy was offered to patients with no radiologic or clinical evidence of nipple involvement.
There were 2,182 NSM performed from 2007 to 2016. Long-term outcomes were assessed in the 311 NSM performed in 2007 to 2012 for Stages 0 to 3 breast cancer; 240 (77%) NSM were for invasive cancer and 71 (23%) were for ductal carcinoma in situ. At 51 months median follow-up, 17 patients developed a recurrence of their cancer. Estimated disease-free survival was 95.7% at 3 years and 92.3% at 5 years. There were 11 (3.7%) locoregional recurrences and 8 (2.7%) distant recurrences; 2 patients had simultaneous locoregional and distant recurrences. There were 2 breast cancer-related deaths in patients with isolated distant recurrences. No patient in the entire 2,182 NSM cohort has had a recurrence in the retained nipple-areola complex.
Rates of locoregional and distant recurrence are acceptably low after nipple-sparing mastectomy in patients with breast cancer. No patient in our series has had a recurrence involving the retained nipple areola complex.
保乳乳头切除术（NSM）在乳腺癌的治疗和预防方面越来越受欢迎。关于该手术的长期肿瘤学安全性数据有限。
我们回顾了单机构连续进行的治疗性 NSM 的肿瘤学结果。为没有影像学或临床乳头受累证据的患者提供 NSM。
2007 年至 2016 年共进行了 2182 例 NSM。对 2007 年至 2012 年期间为 0 至 3 期乳腺癌进行的 311 例 NSM 的长期结果进行了评估；240 例（77%）为浸润性癌，71 例（23%）为导管原位癌。在中位随访 51 个月时，17 例患者癌症复发。估计 3 年无病生存率为 95.7%，5 年无病生存率为 92.3%。有 11 例（3.7%）局部区域复发和 8 例（2.7%）远处复发；2 例患者同时出现局部区域和远处复发。在孤立性远处复发的患者中有 2 例死于乳腺癌。在整个 2182 例 NSM 队列中，没有患者在保留的乳头乳晕复合体中出现复发。
在乳腺癌患者中进行 NSM 后，局部区域和远处复发的发生率可接受较低。我们的系列中没有患者出现涉及保留的乳头乳晕复合体的复发。
