Comparison of oncological safety between nipple sparing mastectomy and total mastectomy using propensity score matching.
BACKGROUND
Although nipple sparing mastectomy (NSM) has attracted increased recognition as an alternative to traditional mastectomy approaches, its oncological safety is unclear. The purpose of this study was to compare the local recurrence rate between NSM and total mastectomy (TM).


METHODS
Between 2003 and 2013, 121 and 557 patients with stage 0-III breast cancer underwent NSM and TM respectively. Multivariate Cox regression and propensity score models were used to compare the two groups.


RESULTS
There was no significant difference in the five-year local recurrence rate between the NSM and TM groups (7.6% vs 4.9%, p=0.398). In multivariate analysis, NSM was not a risk factor for local recurrence (hazard ratio: 1.653, 95% confidence interval: 0.586-4.663, p=0.343). Propensity score matching found similar five-year local recurrence free survival rates between the two groups (92.3% vs 93.7%, p=0.655).


CONCLUSIONS
Our results suggest that NSM may provide oncological safety comparable with mastectomy for carefully selected patients.
Keio University, Tokyo, Japan.
T
T
Seki
Keio University, Tokyo, Japan.
H
H
Jinno
Keio University, Tokyo, Japan.
K
K
Okabayashi
Keio University, Tokyo, Japan.
T
T
Murata
Keio University, Tokyo, Japan.
A
A
Matsumoto
Keio University, Tokyo, Japan.
M
M
Takahashi
Keio University, Tokyo, Japan.
T
T
Hayashida
Keio University, Tokyo, Japan.
Y
Y
Kitagawa
D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D008875:Middle Aged; D009558:Nipples / Q000601:surgery*; D059351:Organ Sparing Treatments / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D057216:Propensity Score; D012189:Retrospective Studies
Breast cancer; Nipple sparing mastectomy; Propensity score matching