| Title |
Nipple-Sparing Mastectomy in Irradiated Breasts: Selecting Patients to Minimize Complications
|
|---|---|
| Published in |
Annals of Surgical Oncology, July 2015
|
| DOI | 10.1245/s10434-015-4669-y |
| Pubmed ID | |
| Authors |
Rong Tang, Suzanne B. Coopey, Amy S. Colwell, Michelle C. Specht, Michele A. Gadd, Kari Kansal, Maureen P. McEvoy, Andrea L. Merrill, Upahvan Rai, Alphonse Taghian, William G. Austen, Barbara L. Smith |
| Abstract |
Nipple-sparing mastectomies (NSM) are increasingly common because of their cosmetic advantage. Radiotherapy (RT) has been a relative contraindication to immediate reconstruction because of concerns about increased complications. We aimed to evaluate outcomes of NSM plus immediate reconstruction in irradiated breasts and to determine additional risk factors for complications. We retrospectively reviewed NSM with immediate reconstruction from 2007 to 2013 at our institution. Complications were broken down into several categories. Potential risk factors for complications were evaluated. There were 982 NSM: 816 had no RT, 67 had prior RT, and 97 had postmastectomy radiotherapy (PMRT). Compared to breasts with no RT, both prior RT and PMRT increased overall complications (10.2 vs. 21.7 and 17.5 %, p = 0.003, 0.03, respectively) and nipple loss (0.9 vs. 4.3 and 4.1 %, p = 0.04, 0.02, respectively), while PMRT increased rate of reconstruction failure (2.2 vs. 8.2 %, p = 0.003). On multivariate regression analysis, prior RT [odds ratio (OR) 2.53, p = 0.006], PMRT (OR 2.29, p = 0.015), age >55 years (OR 2.03, p = 0.04), breast volume ≥800 cm(3) (OR 1.96, p = 0.04), smoking (OR 2.62, p = 0.001), and periareolar incision (OR 1.74, p = 0.03) were independent risk factors for complications requiring surgical revision. In irradiated breasts, complication rates were 13.4 % without further risk factors and 17.5, 50, and 66.7 % when 1, 2, and ≥3 additional independent risk factors were present, respectively (p < 0.001). Although complication rates were higher in irradiated breasts, reconstruction failure and nipple/areola necrosis was infrequent. RT should not be a contraindication to NSM. Preoperative identification of risk factors and appropriate patient selection may reduce complication rates. |
X Demographics
The data shown below were collected from the profiles of 31 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 15 | 48% |
| Spain | 2 | 6% |
| Ireland | 1 | 3% |
| Argentina | 1 | 3% |
| Netherlands | 1 | 3% |
| Canada | 1 | 3% |
| Italy | 1 | 3% |
| Sao Tome and Principe | 1 | 3% |
| Unknown | 8 | 26% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 21 | 68% |
| Practitioners (doctors, other healthcare professionals) | 8 | 26% |
| Scientists | 2 | 6% |
Mendeley readers
The data shown below were compiled from readership statistics for 48 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Denmark | 1 | 2% |
| Italy | 1 | 2% |
| Unknown | 46 | 96% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 7 | 15% |
| Student > Doctoral Student | 6 | 13% |
| Student > Bachelor | 5 | 10% |
| Researcher | 5 | 10% |
| Student > Postgraduate | 3 | 6% |
| Other | 7 | 15% |
| Unknown | 15 | 31% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 25 | 52% |
| Biochemistry, Genetics and Molecular Biology | 1 | 2% |
| Business, Management and Accounting | 1 | 2% |
| Neuroscience | 1 | 2% |
| Chemistry | 1 | 2% |
| Other | 2 | 4% |
| Unknown | 17 | 35% |
Attention Score in Context
This research output has an Altmetric Attention Score of 31. 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 11 June 2019.
All research outputs
#1,151,715
of 23,577,761 outputs
Outputs from Annals of Surgical Oncology
#133
of 6,673 outputs
Outputs of similar age
#15,374
of 265,200 outputs
Outputs of similar age from Annals of Surgical Oncology
#2
of 126 outputs
Altmetric has tracked 23,577,761 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,673 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.4. This one has done particularly well, scoring higher than 98% of its peers.
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We're also able to compare this research output to 126 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 98% of its contemporaries.