Outcomes and feasibility of nipple-sparing mastectomy for node-positive breast cancer Patients.
BACKGROUND
While nipple-sparing mastectomy (NSM) is gaining acceptance for risk reduction and for treatment of early stage breast cancer, node-positive disease remains a relative contraindication. Our aim was to evaluate the use and outcomes of NSM in node-positive breast cancer patients.


METHODS
We identified 240 cancers in 226 patients (14 bilateral) scheduled for NSM and operated on between 1/2009 and 6/2014. We compared outcomes for 58 node-positive vs 182 node-negative patients.


RESULTS
Intraoperative conversion to skin-sparing mastectomy was similar for node-positive and node-negative patients, 10% and 7%, as was 1-year success of NSM, 84% and 90%, respectively. Five-year locoregional disease-free estimates were 82% (95% CI 68%-99%) for node-positive and 99% (95% CI 96%-100%) for node-negative patients, P = .004; however, there were no nipple-areolar recurrences among node-positive patients.


CONCLUSIONS
With careful consideration of biologic and anatomic risk factors for recurrence, these data suggest that NSM is a reasonable option for selected node-positive breast cancer patients.
Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Brittany L
BL
Murphy
Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Tanya L
TL
Hoskin
Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Judy C
JC
Boughey
Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Amy C
AC
Degnim
Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
James W
JW
Jakub
Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Adam C
AC
Krajewski
Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Steven R
SR
Jacobson
Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address: hieken.tina@mayo.edu.
Tina J
TJ
Hieken
D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000601:surgery; D018275:Carcinoma, Lobular / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D015414:Mastectomy, Subcutaneous; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local
Breast cancer; Local recurrence; Lymph node; Nipple-sparing mastectomy; Node-positive; Outcomes