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Evolving indications and long-term oncological outcomes of risk-reducing bilateral nipple-sparing mastectomy.
- Source :
-
BJS open [BJS Open] 2018 Nov 26; Vol. 3 (2), pp. 169-173. Date of Electronic Publication: 2018 Nov 26 (Print Publication: 2019). - Publication Year :
- 2018
-
Abstract
- Background: Bilateral nipple-sparing mastectomy (NSM) is a technically feasible operation and is associated with excellent cosmetic outcomes. The aim of this study was to evaluate trends in patient characteristics, indications for surgery and long-term outcomes of bilateral NSM for breast cancer risk reduction over time.<br />Methods: A review of a single-centre experience with bilateral NSM performed between 2001 and 2017 for breast cancer risk reduction in patients without breast cancer was performed. Trends in patient characteristics and indications for surgery were evaluated over four time intervals: 2001-2005, 2006-2009, 2010-2013 and 2014-2017. Statistical analysis was performed using χ <superscript>2</superscript> tests.<br />Results: Over the study period, 272 NSMs were performed in 136 patients; their median age was 41 years. The number of bilateral NSMs performed increased over time. The most common indication was a mutation in breast cancer-associated genes (104 patients, 76·5 per cent), which included BRCA1 (62 patients), BRCA2 (35), PTEN (2), TP53 (3) and ATM (2). Other indications were family history of breast cancer (19 patients, 14·0 per cent), lobular carcinoma in situ (10, 7·4 per cent) and a history of mantle irradiation (3, 2·2 per cent). The proportion of patients having a bilateral NSM for mutation in a breast cancer-associated gene increased over time (2001-2005: 2 of 12; 2006-2009: 9 of 17; 2010-2013: 34 of 41; 2014-2017: 61 of 66; P < 0·001). Mean follow-up was 53 months; no breast cancers were found during follow-up.<br />Conclusion: The use of bilateral NSM for breast cancer risk reduction is increasing and the indications have evolved over the past 16 years. These excellent long-term oncological results suggest that bilateral NSM is a good option for surgical breast cancer risk reduction.
- Subjects :
- Adult
Aged
Breast Neoplasms genetics
Breast Neoplasms, Male genetics
Female
Follow-Up Studies
Germ-Line Mutation
Humans
Male
Mastectomy, Subcutaneous adverse effects
Medical History Taking
Middle Aged
Nipples surgery
Organ Sparing Treatments adverse effects
Patient Selection
Prophylactic Mastectomy adverse effects
Retrospective Studies
Treatment Outcome
Young Adult
Biomarkers, Tumor genetics
Breast Neoplasms surgery
Breast Neoplasms, Male surgery
Mastectomy, Subcutaneous methods
Organ Sparing Treatments methods
Prophylactic Mastectomy methods
Subjects
Details
- Language :
- English
- ISSN :
- 2474-9842
- Volume :
- 3
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- BJS open
- Publication Type :
- Academic Journal
- Accession number :
- 30957063
- Full Text :
- https://doi.org/10.1002/bjs5.50117