| Title |
Tumor Involvement of the Nipple in Total Skin-Sparing Mastectomy: Strategies for Management
|
|---|---|
| Published in |
Annals of Surgical Oncology, May 2015
|
| DOI | 10.1245/s10434-015-4646-5 |
| Pubmed ID | |
| Authors |
Dominic Amara, Anne Warren Peled, Frederick Wang, Cheryl A. Ewing, Michael Alvarado, Laura J. Esserman |
| Abstract |
Despite a growing body of literature on oncologic and reconstructive outcomes after total skin-sparing mastectomy (TSSM), some questions related to this approach remain unanswered, including strategies for managing tumor involvement of the nipple while maintaining the aesthetic benefits of TSSM. A prospectively maintained database of patients undergoing TSSM and immediate breast reconstruction from 2005 to 2013 was reviewed. Outcomes included tumor involvement of resected nipple tissue and subsequent management, recurrences after nipple involvement, and trends in management of involved nipple tissue. The study included 1176 breasts in 751 patients treated with TSSM. The follow-up period was 31.3 months. The nipple-areolar complex (NAC) of 32 breasts (2.7 %) had a positive margin or involvement of nipple tissue. Of these breasts, 56 % contained invasive cancer, and 44 % had in situ disease. Management included repeat excision (11 cases, 34 % of cases), radiation of the NAC (as part of the postmastectomy breast field) without further excision (5 cases, 16 %), complete NAC removal (8 cases, 25 %), and no further treatment (8 cases, 25 %). Management by complete NAC skin excision significantly decreased during the study period (p = 0.003). The overall local recurrence rate was 6.2 %. No patients had recurrence in the preserved NAC skin. Despite expanding indications for TSSM, it can be performed safely with low rates of nipple involvement. Over time, tumor involvement of the nipple has been treated with re-excision or other alternative approaches to NAC removal that preserve the aesthetic benefits of total skin-sparing approaches without an early adverse impact on local recurrence. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 35 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 3% |
| Italy | 1 | 3% |
| Unknown | 33 | 94% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 5 | 14% |
| Student > Master | 5 | 14% |
| Student > Doctoral Student | 3 | 9% |
| Student > Bachelor | 3 | 9% |
| Student > Ph. D. Student | 2 | 6% |
| Other | 7 | 20% |
| Unknown | 10 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 19 | 54% |
| Business, Management and Accounting | 1 | 3% |
| Nursing and Health Professions | 1 | 3% |
| Psychology | 1 | 3% |
| Agricultural and Biological Sciences | 1 | 3% |
| Other | 2 | 6% |
| Unknown | 10 | 29% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 31 May 2015.
All research outputs
#18,411,569
of 22,807,037 outputs
Outputs from Annals of Surgical Oncology
#4,972
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Outputs of similar age
#192,112
of 265,918 outputs
Outputs of similar age from Annals of Surgical Oncology
#42
of 67 outputs
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