BJS open · 2026
Long-term oncological outcomes after nipple-sparing mastectomy and implant-based immediate breast reconstruction in a population-based cohort of breast cancer patients.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Sackey Helena, Oikonomou Ira, Liu Yihang, Frisell Axel, Coudé Adam Hannah, Ansarei Dhirar, Halle Martin, Johansson Anna L V, de Boniface Jana
Аннотация
BACKGROUND: Nipple-sparing mastectomy (NSM) offers superior cosmetic and patient-reported outcomes compared with skin-sparing mastectomy (SSM), although its oncological safety remains debated. This study evaluated recurrence and survival after NSM versus SSM in women with breast cancer receiving implant-based immediate breast reconstruction (IBR).
METHODS: The population-based Stockholm Breast Reconstruction Database, including all women with breast cancer who underwent implant-based IBR in Stockholm from 2005 to 2015, was reviewed. Data were collected from medical chart review and the National Quality Register for Breast Cancer. The primary outcomes were long-term local recurrence (LR) rates and overall survival (OS) after NSM versus SSM. Survival probabilities and hazard ratios (HR) with their 95% confidence interval (c.i.) were estimated with a maximum 12 years of follow-up.
RESULTS: Of 1687 patients registered in the database, this analysis included 1594 implant-based IBRs performed in 1537 women with primary breast cancer. Of these, 86.3% (1376 breasts) had SSM and 13.7% had NSM (218 breasts). The median follow-up was 75 months for SSM and 60 months for NSM. The use of NSM increased from 7.6% in 2005-2007 to 26.6% in 2014-2015 (P < 0.001). LR occurred in 50 breasts, 13 after NSM and 37 after SSM, with a 12-year cumulative incidence of 14.1% for NSM and 3.7% for SSM (P = 0.001). Among the 13 LRs after NSM, 4 (30.8%) were localized in or beneath the nipple-areola complex. The unadjusted HR was 3.18 (95% c.i. 1.67 to 6.03) and remained significant in the multivariable analysis (HR 2.08; 95% c.i. 1.01 to 4.28). OS did not differ significantly (HR 0.74; 95% c.i. 0.38 to 1.44).
CONCLUSION: NSM was associated with an increased risk of LR compared with SSM, whereas no significant association with OS was observed. Whether these results can be attributed to more residual breast glandular tissue needs to be evaluated in further research.
METHODS: The population-based Stockholm Breast Reconstruction Database, including all women with breast cancer who underwent implant-based IBR in Stockholm from 2005 to 2015, was reviewed. Data were collected from medical chart review and the National Quality Register for Breast Cancer. The primary outcomes were long-term local recurrence (LR) rates and overall survival (OS) after NSM versus SSM. Survival probabilities and hazard ratios (HR) with their 95% confidence interval (c.i.) were estimated with a maximum 12 years of follow-up.
RESULTS: Of 1687 patients registered in the database, this analysis included 1594 implant-based IBRs performed in 1537 women with primary breast cancer. Of these, 86.3% (1376 breasts) had SSM and 13.7% had NSM (218 breasts). The median follow-up was 75 months for SSM and 60 months for NSM. The use of NSM increased from 7.6% in 2005-2007 to 26.6% in 2014-2015 (P < 0.001). LR occurred in 50 breasts, 13 after NSM and 37 after SSM, with a 12-year cumulative incidence of 14.1% for NSM and 3.7% for SSM (P = 0.001). Among the 13 LRs after NSM, 4 (30.8%) were localized in or beneath the nipple-areola complex. The unadjusted HR was 3.18 (95% c.i. 1.67 to 6.03) and remained significant in the multivariable analysis (HR 2.08; 95% c.i. 1.01 to 4.28). OS did not differ significantly (HR 0.74; 95% c.i. 0.38 to 1.44).
CONCLUSION: NSM was associated with an increased risk of LR compared with SSM, whereas no significant association with OS was observed. Whether these results can be attributed to more residual breast glandular tissue needs to be evaluated in further research.