Do clinicopathological features of the cancer patient relate with nipple areolar complex necrosis in nipple-sparing mastectomy?

Background: The selections of nipple-sparing mastectomy (NSM) are principally depending on oncologic indication and oncologic safety. The main complication of NSM is nipple areolar complex (NAC) necrosis, and it is usually related to surgical technique. However, the patients' clinicopathologica...

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Main Authors: Visnu Lohsiriwat, Nicole Rotmensz, Edoardo Botteri, Mattia Intra, Paolo Veronesi, Stefano Martella, Cristina Garusi, Francesca De Lorenzi, Andrea Manconi, Giuseppe Lomeo, Mario Rietjens, Mario Schorr, Maximiliano Cassilha Kneubil, Jean Yves Petit
Other Authors: Istituto Europeo di Oncologia
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Published: 2018
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/32454
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spelling th-mahidol.324542018-10-19T12:29:59Z Do clinicopathological features of the cancer patient relate with nipple areolar complex necrosis in nipple-sparing mastectomy? Visnu Lohsiriwat Nicole Rotmensz Edoardo Botteri Mattia Intra Paolo Veronesi Stefano Martella Cristina Garusi Francesca De Lorenzi Andrea Manconi Giuseppe Lomeo Mario Rietjens Mario Schorr Maximiliano Cassilha Kneubil Jean Yves Petit Istituto Europeo di Oncologia Mahidol University Universita degli Studi di Milano Medicine Background: The selections of nipple-sparing mastectomy (NSM) are principally depending on oncologic indication and oncologic safety. The main complication of NSM is nipple areolar complex (NAC) necrosis, and it is usually related to surgical technique. However, the patients' clinicopathological factors should be also considered. Method: We retrospectively reviewed 934 consecutive NSM patients during 2002-2007 at the European Institute of Oncology, Milan, Italy. We identified a group of patient who had NAC excision because of NAC necrosis and compared this group with those who had successful NAC conservation. We analyzed the association between the risk of NAC necrosis and the clinicopathological features of the patients. Results: Among 934 NSM, 772 were invasive cancers and 162 were in situ cancers. Of the 934, 40 NAC (4.2 %) were removed during the postoperative period because of necrosis. When we considered age, BMI, menopausal status, smoking status, tumor size, axillary lymph node status, in situ or invasive cancer histology, presence of extensive situ component, grading, estrogen receptor, progesterone receptor, HER2/neu overexpression, Ki-67 proliferative index, and peritumoral vascular invasion, no association was observed between patients' clinicopathological features and NAC necrosis incidence. Conclusions: In our study, clinicopathological features have no significant impact on necrosis complication in therapeutic NSMs. Positive retroareolar margin is the risk of necrosis. Further studies are required to avoid bias due to the different cancer treatments such as different reconstruction techniques and intraoperative radiation protocols. The correlation between breast morphology and NAC necrosis should also be investigated in the future. © 2012 Society of Surgical Oncology. 2018-10-19T05:29:59Z 2018-10-19T05:29:59Z 2013-03-01 Article Annals of Surgical Oncology. Vol.20, No.3 (2013), 990-996 10.1245/s10434-012-2677-8 15344681 10689265 2-s2.0-84875229735 https://repository.li.mahidol.ac.th/handle/123456789/32454 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84875229735&origin=inward
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Medicine
spellingShingle Medicine
Visnu Lohsiriwat
Nicole Rotmensz
Edoardo Botteri
Mattia Intra
Paolo Veronesi
Stefano Martella
Cristina Garusi
Francesca De Lorenzi
Andrea Manconi
Giuseppe Lomeo
Mario Rietjens
Mario Schorr
Maximiliano Cassilha Kneubil
Jean Yves Petit
Do clinicopathological features of the cancer patient relate with nipple areolar complex necrosis in nipple-sparing mastectomy?
description Background: The selections of nipple-sparing mastectomy (NSM) are principally depending on oncologic indication and oncologic safety. The main complication of NSM is nipple areolar complex (NAC) necrosis, and it is usually related to surgical technique. However, the patients' clinicopathological factors should be also considered. Method: We retrospectively reviewed 934 consecutive NSM patients during 2002-2007 at the European Institute of Oncology, Milan, Italy. We identified a group of patient who had NAC excision because of NAC necrosis and compared this group with those who had successful NAC conservation. We analyzed the association between the risk of NAC necrosis and the clinicopathological features of the patients. Results: Among 934 NSM, 772 were invasive cancers and 162 were in situ cancers. Of the 934, 40 NAC (4.2 %) were removed during the postoperative period because of necrosis. When we considered age, BMI, menopausal status, smoking status, tumor size, axillary lymph node status, in situ or invasive cancer histology, presence of extensive situ component, grading, estrogen receptor, progesterone receptor, HER2/neu overexpression, Ki-67 proliferative index, and peritumoral vascular invasion, no association was observed between patients' clinicopathological features and NAC necrosis incidence. Conclusions: In our study, clinicopathological features have no significant impact on necrosis complication in therapeutic NSMs. Positive retroareolar margin is the risk of necrosis. Further studies are required to avoid bias due to the different cancer treatments such as different reconstruction techniques and intraoperative radiation protocols. The correlation between breast morphology and NAC necrosis should also be investigated in the future. © 2012 Society of Surgical Oncology.
author2 Istituto Europeo di Oncologia
author_facet Istituto Europeo di Oncologia
Visnu Lohsiriwat
Nicole Rotmensz
Edoardo Botteri
Mattia Intra
Paolo Veronesi
Stefano Martella
Cristina Garusi
Francesca De Lorenzi
Andrea Manconi
Giuseppe Lomeo
Mario Rietjens
Mario Schorr
Maximiliano Cassilha Kneubil
Jean Yves Petit
format Article
author Visnu Lohsiriwat
Nicole Rotmensz
Edoardo Botteri
Mattia Intra
Paolo Veronesi
Stefano Martella
Cristina Garusi
Francesca De Lorenzi
Andrea Manconi
Giuseppe Lomeo
Mario Rietjens
Mario Schorr
Maximiliano Cassilha Kneubil
Jean Yves Petit
author_sort Visnu Lohsiriwat
title Do clinicopathological features of the cancer patient relate with nipple areolar complex necrosis in nipple-sparing mastectomy?
title_short Do clinicopathological features of the cancer patient relate with nipple areolar complex necrosis in nipple-sparing mastectomy?
title_full Do clinicopathological features of the cancer patient relate with nipple areolar complex necrosis in nipple-sparing mastectomy?
title_fullStr Do clinicopathological features of the cancer patient relate with nipple areolar complex necrosis in nipple-sparing mastectomy?
title_full_unstemmed Do clinicopathological features of the cancer patient relate with nipple areolar complex necrosis in nipple-sparing mastectomy?
title_sort do clinicopathological features of the cancer patient relate with nipple areolar complex necrosis in nipple-sparing mastectomy?
publishDate 2018
url https://repository.li.mahidol.ac.th/handle/123456789/32454
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