• Barbara L Smith, Rong Tang, Upahvan Rai, Jennifer K Plichta, Amy S Colwell, Michele A Gadd, Michelle C Specht, William G Austen, and Suzanne B Coopey.
• Division of Surgical Oncology, Massachusetts General Hospital, Boston, MA. Electronic address: blsmith1@mgh.harvard.edu.
• J. Am. Coll. Surg. 2017 Sep 1; 225 (3): 361-365.

BackgroundNipple-sparing mastectomy (NSM) has gained popularity for breast cancer treatment and prevention. There are limited data about long-term oncologic safety of this procedure.Study DesignWe reviewed oncologic outcomes of consecutive therapeutic NSM at a single institution. Nipple-sparing mastectomy was offered to patients with no radiologic or clinical evidence of nipple involvement.ResultsThere were 2,182 NSM performed from 2007 to 2016. Long-term outcomes were assessed in the 311 NSM performed in 2007 to 2012 for Stages 0 to 3 breast cancer; 240 (77%) NSM were for invasive cancer and 71 (23%) were for ductal carcinoma in situ. At 51 months median follow-up, 17 patients developed a recurrence of their cancer. Estimated disease-free survival was 95.7% at 3 years and 92.3% at 5 years. There were 11 (3.7%) locoregional recurrences and 8 (2.7%) distant recurrences; 2 patients had simultaneous locoregional and distant recurrences. There were 2 breast cancer-related deaths in patients with isolated distant recurrences. No patient in the entire 2,182 NSM cohort has had a recurrence in the retained nipple-areola complex.ConclusionsRates of locoregional and distant recurrence are acceptably low after nipple-sparing mastectomy in patients with breast cancer. No patient in our series has had a recurrence involving the retained nipple areola complex.Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

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