Investigation of the current situation of nipple-sparing mastectomy: a large multicenter study in China (CSBrs-003).

Publisher: Chinese Medical Association ; produced by Wolters Kluwer Country of Publication: China NLM ID: 7513795 Publication Model: Electronic Cited Medium: Internet ISSN: 2542-5641 (Electronic) Linking ISSN: 03666999 NLM ISO Abbreviation: Chin Med J (Engl) Subsets: MEDLINE

Publication: <2015- > : Beijing : Chinese Medical Association ; produced by Wolters Kluwer
Original Publication: Peking, Chinese Medical Assn.

Breast Neoplasms*/surgery ; Mammaplasty*; China ; Humans ; Mastectomy ; Nipples/surgery ; Prospective Studies ; Retrospective Studies

Background: Mastectomy techniques have been extended to nipple-sparing mastectomy (NSM). This study aimed to assess the actual application of NSM in China and identify the factors influencing postoperative complications.
Methods: The clinical data of 615 patients (641 surgeries) undergoing NSM from January 1st, 2018 to December 31st, 2018 at 28 centers nationwide were retrospectively analyzed to obtain the rate of NSM and investigate factors related to NSM surgery.
Results: The proportion of NSM surgery performed in this study was 2.67% (17/641). Malignant breast tumors accounted for the majority of NSM surgery (559/641, 87.2%). A total of 475 (77.3%) patients underwent NSM combined with reconstructive surgery. The rate of reconstruction decreased with age in our study, and implants were the most common option (344/641, 53.7%) in reconstruction. Radial incision was the most selected method regardless of reconstruction. However, for those who underwent reconstruction surgery, 18.4% (85/462) of cases also chose curvilinear incision, while in the simple NSM surgery group, more patients chose circumareolar incision (26/136, 19.1%). The tumor-to-nipple distance (TND) influenced postoperative complications (P = 0.004). There were no relationships between postoperative complications and tumor size, tumor location, histologic grade, molecular subtype, nipple discharge, and axillary lymph nodes.
Conclusions: NSM surgery is feasible and only TND influenced postoperative complications of NSM surgery. But the proportion of NSM surgery performed is still low in nationwide centers of China. The selection criteria for appropriate surgical methods are important for NSM in clinical practice. To optimize clinical applications of NSM, further multicenter prospective randomized controlled studies are needed.
Trial Registration: ChiCTR.org.cn, ChiCTR1900027423; http://www.chictr.org.cn/showprojen.aspx?proj=38739.
(Copyright © 2021 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.)

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Date Created: 20210120 Date Completed: 20210512 Latest Revision: 20210520

20221213

PMC8104227

10.1097/CM9.0000000000001350

33470653