title: Therapeutic nipple-sparing mastectomy: trends based on a national cancer database.
abstract: BACKGROUND
  Current reports on nipple-sparing mastectomy (NSM) are limited to single-institution series. We use the National Cancer Institute's Surveillance, Epidemiology, and End Results database to report on the national experience with NSM.
  
  
  METHODS
  Population-level deidentified data were extracted from the Surveillance, Epidemiology, and End Results database. All female breast cancer patients treated with NSM from 2005 to 2009 were included. Case analysis was performed with respect to demographic and oncologic characteristics.
  
  
  RESULTS
  Four hundred forty-nine patients underwent therapeutic NSM; this number increased from 66 patients in 2005 to 133 in 2009. Patients were distributed across 16 regions, although nearly 50% were from a region of California. Tumor diameter was <2 cm in 224 patients (50%). Lymph nodes were positive in 59 patients (13%), while radiation was delivered to 74 patients (16%).
  
  
  CONCLUSIONS
  NSM use has been increasing over the past several years. A majority of patients have tumor size <2 cm, although the number of patients with tumor size ≥2 cm has increased over time. Further population-based studies of NSM may benefit from collection of oncologic data such as tumor-to-nipple distance and tumor location.
authors.affiliation: Department of Surgery, University of Michigan Medical School, Ann Arbor, MI, USA.
authors.forename: Shailesh
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: Sunil
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT 84132, USA.
authors.forename: Leigh
authors.initials: L
authors.lastname: Neumayer
authors.affiliation: Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT 84132, USA. Electronic address: Jay.Agarwal@hsc.utah.edu.
authors.forename: Jayant P
authors.initials: JP
authors.lastname: Agarwal
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D015414:Mastectomy, Subcutaneous / Q000706:statistics & numerical data / Q000639:trends*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D018714:Radiotherapy, Adjuvant; D018426:SEER Program; D015996:Survival Rate; D016896:Treatment Outcome; D047368:Tumor Burden; D014481:United States
keywords: Breast cancer; Nipple-sparing mastectomy; SEER; Subcutaneous mastectomy