• T Muller, A Baratte, C Bruant-Rodier, F Bodin, and C Mathelin.
• Service de chirurgie esthétique et réparatrice, CHRU, hôpitaux universitaires de Strasbourg, hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
• Ann Chir Plast Esthet. 2018 Jun 1; 63 (3): e6-e13.

IntroductionThe objective of our study was to evaluate the risk of cancer after prophylactic nipple-sparing mastectomy (PNSM).Material And MethodsThe PubMed database was consulted using the following key-words: "nipple-sparing mastectomy", "prophylactic", "locoregional recurrence", "oncological risk". Articles published between January 1995 and December 2016 were searched.ResultsOut of the 270 articles found, 19 were included. Overall, 15 studies were retrospective, 2 prospective, 2 prospective and retrospective and 3 were multicentric. All told, they involved 3890 patients corresponding to 6786 mastectomies, among which the total number of prophylactic nipple-sparing mastectomies was 3716. Average age of the patients was 44.4years and average follow-up was 38.4months (8-168months); 29.4% of them had a BRCA 1 or 2 mutation; 85 and 15% underwent prosthetic and autologous reconstructions, respectively. Average cancer rates exterior to and within the nipple areolar complex (NAC) were 0.2 and 0.004%, respectively. The overall average rate of histological pre-malignant lesions in the nipple areolar complex was 1.5%. The overall complication rate was 20.5%, and necrosis rates of the nipple areolar complex and the skin were 8.1 and 7.1%, respectively.ConclusionIn prophylactic breast surgery, conservation of the nipple areolar complex does not seem to increase the risk of cancer development. However, short follow-up time and the different methodologies applied in the different studies presently preclude generalization of the technique.Copyright © 2017 Elsevier Masson SAS. All rights reserved.

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