Oncological Safety of Nipple-sparing Mastectomy After Neoadjuvant Chemotherapy: a Systematic Review

Overview

Journal Rev Col Bras Cir

Specialty General Surgery

Date 2023 Aug 9

PMID 37556611

Authors

Leonardo Nissen

Isabela Chaves Monteiro Soares

Rubens Silveira DE Lima

Cicero de Andrade Urban

Iris Rabinovich

Affiliations

Soon will be listed here.

Abstract

Background: the use of nipple-sparing mastectomy (NSM) in local advanced breast cancer after neoadjuvant chemotherapy (NQT) is increasing, despite few studies on the subject. The aim of this systematic review was to determine the safety of NSM after neoadjuvant chemotherapy.

Methods: for this systematic review we searched MEDLINE; Cochrane; Scientific Electronic Library Online (SciELO); Embase and Scopus. A literature search of all original studies including randomized controlled trials, cohort studies and case-control studies comparing women undergoing NSM after neoadjuvant chemotherapy for breast cancer was undertaken. Outcomes were locoregional recurrence (LRR), nipple recurrence and distant recurrence (DR). Data analysis was undertaken to explore the safety of NSM after NQT. The quality of the evidence was assessed with the Cochrane risk of bias tool. This study is registered on PROSPERO, number CRD42021276778.

Findings: a total of 437 articles were identified. Four articles were included with 1466 patients all of which had a high to serious risk of overall bias. Local recurrence in the NSM after the NQT group ranged from zero to 9.8%. Nippleareolar complex (NAC) recurrence ranged from zero to 2.1%. The distant recurrence rate ranged from 6.5% to 16%. Due to the lack of pattern among the control groups, it was not possible to perform a meta-analysis.

Interpretation: this review provides information for decision making in performing NSM after NQT. Despite the low rates of local recurrence and patients should be counseled about limited oncological information.

Citing Articles

Long-Term Follow-Up of Surgical Outcomes and Oncological Results of Nipple-Sparing Mastectomy with Immediate Reconstruction Through a Single Axillary Incision with Different Approach Methods.

Gau R, Chou H, Tsai H, Shen S, Kuo W, Chu C Ann Surg Oncol. 2024; 32(3):2092-2102.

PMID: 39710805 DOI: 10.1245/s10434-024-16672-0.

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