open access

Vol 71, No 3 (2021)
Research paper (original)
Published online: 2021-02-22
Get Citation

Skin-sparing and nipple-sparing mastectomy with a positive sentinel node in patients with breast cancer

Piotr Kędzierawski12, Artur Bocian2, Ryszard Mężyk2
·
Nowotwory. Journal of Oncology 2021;71(3):153-157.
Affiliations
  1. Collegium Medicum, Jan Kochanowski University, Kielce, Poland
  2. The Holycross Cancer Centre, Kielce, Poland

open access

Vol 71, No 3 (2021)
Original article
Published online: 2021-02-22

Abstract

Introduction. A skin-sparing or nipple-sparing mastectomy is a surgical treatment that is increasingly used in the treatment of patients with breast cancer. More often women themselves decide or even ask to undergo this type of surgery. In our paper, we present the issue of combined treatment of 62 patients after nipple-sparing or skin-sparing mastectomy with a positive sentinel lymph node. Realisation of this type of surgery has further consequences in adjuvant treatment policies.

Material and methods. The group of 62 previously untreated women with positive sentinel lymph nodes took part in this analysis. The individual plan of treatment was established for every patient by the multidisciplinary team according to the rules of the breast cancer unit. All patients were treated in the Holycross Cancer Centre in Kielce (in 2015–2018).

Results. The early results show that proper qualification and realisation of oncological treatment is safe and effective. Severe complications appeared rarely.

Conclusions. Skin-sparing or nipple-sparing mastectomy is a method of surgical treatment that is increasingly used in the treatment of patients with breast cancer. It should be remembered that the qualification for this type of procedure should be careful, and adjuvant treatment should be rationally planned. Our experience shows that it is an effective and safe method.

Abstract

Introduction. A skin-sparing or nipple-sparing mastectomy is a surgical treatment that is increasingly used in the treatment of patients with breast cancer. More often women themselves decide or even ask to undergo this type of surgery. In our paper, we present the issue of combined treatment of 62 patients after nipple-sparing or skin-sparing mastectomy with a positive sentinel lymph node. Realisation of this type of surgery has further consequences in adjuvant treatment policies.

Material and methods. The group of 62 previously untreated women with positive sentinel lymph nodes took part in this analysis. The individual plan of treatment was established for every patient by the multidisciplinary team according to the rules of the breast cancer unit. All patients were treated in the Holycross Cancer Centre in Kielce (in 2015–2018).

Results. The early results show that proper qualification and realisation of oncological treatment is safe and effective. Severe complications appeared rarely.

Conclusions. Skin-sparing or nipple-sparing mastectomy is a method of surgical treatment that is increasingly used in the treatment of patients with breast cancer. It should be remembered that the qualification for this type of procedure should be careful, and adjuvant treatment should be rationally planned. Our experience shows that it is an effective and safe method.

Get Citation

Keywords

breast cancer; skin-sparing mastectomy; nipple-sparing mastectomy; combined treatment

About this article
Title

Skin-sparing and nipple-sparing mastectomy with a positive sentinel node in patients with breast cancer

Journal

Nowotwory. Journal of Oncology

Issue

Vol 71, No 3 (2021)

Article type

Research paper (original)

Pages

153-157

Published online

2021-02-22

Page views

796

Article views/downloads

539

DOI

10.5603/NJO.a2021.0018

Bibliographic record

Nowotwory. Journal of Oncology 2021;71(3):153-157.

Keywords

breast cancer
skin-sparing mastectomy
nipple-sparing mastectomy
combined treatment

Authors

Piotr Kędzierawski
Artur Bocian
Ryszard Mężyk

References (26)
  1. Tokin C, Weiss A, Wang-Rodriguez J, et al. Oncologic safety of skin-sparing and nipple-sparing mastectomy: a discussion and review of the literature. Int J Surg Oncol. 2012; 2012: 921821.
  2. Newman LA, Kuerer HM, Hunt KK, et al. Presentation, treatment, and outcome of local recurrence afterskin-sparing mastectomy and immediate breast reconstruction. Ann Surg Oncol. 1998; 5(7): 620–626.
  3. Greenway RM, Schlossberg L, Dooley WC. Fifteen-year series of skin-sparing mastectomy for stage 0 to 2 breast cancer. Am J Surg. 2005; 190(6): 918–922.
  4. Lim W, Ko BS, Kim HJ, et al. Oncological safety of skin sparing mastectomy followed by immediate reconstruction for locally advanced breast cancer. J Surg Oncol. 2010; 102(1): 39–42.
  5. Greenway RM, Schlossberg L, Dooley WC. Fifteen-year series of skin-sparing mastectomy for stage 0 to 2 breast cancer. Am J Surg. 2005; 190(6): 918–922.
  6. Kroll SS, Khoo A, Singletary SE, et al. Local recurrence risk after skin-sparing and conventional mastectomy: a 6-year follow-up. Plast Reconstr Surg. 1999; 104(2): 421–425.
  7. Langstein HN, Cheng MH, Singletary SE, et al. Breast cancer recurrence after immediate reconstruction: patterns and significance. Plast Reconstr Surg. 2003; 111(2): 712–20; discussion 721.
  8. Medina-Franco H, Vasconez LO, Fix RJ, et al. Factors associated with local recurrence after skin-sparing mastectomy and immediate breast reconstruction for invasive breast cancer. Ann Surg. 2002; 235(6): 814–819.
  9. Lanitis S, Tekkis PP, Sgourakis G, et al. Comparison of skin-sparing mastectomy versus non-skin-sparing mastectomy for breast cancer: a meta-analysis of observational studies. Ann Surg. 2010; 251(4): 632–639.
  10. Jasem J, Krzakowski M, et al. Rak piersi. Onkologia w praktyce klinicznej. 2020; 6(5): 297–352.
  11. Kędzierawski P. Breast cancer – extracapsular extension in the sentinel lymph node. Journal of Oncology. 2020; 70(5): 203–205.
  12. Kroll SS, Khoo A, Singletary SE, et al. Local recurrence risk after skin-sparing and conventional mastectomy: a 6-year follow-up. Plast Reconstr Surg. 1999; 104(2): 421–425.
  13. Petit JY, Veronesi U, Orecchia R, et al. Nipple sparing mastectomy with nipple areola intraoperative radiotherapy: one thousand and one cases of a five years experience at the European institute of oncology of Milan (EIO). Breast Cancer Res Treat. 2009; 117(2): 333–338.
  14. Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials. The Lancet. 2014; 383(9935): 2127–2135.
  15. Marta G, Poortmans P, Barros Ade, et al. Multidisciplinary international survey of post-operative radiation therapy practices after nipple-sparing or skin-sparing mastectomy. Eur J Surg Oncol. 2017; 43(11): 2036–2043.
  16. Niemeyer M, Paepke S, Schmid R, et al. Extended indications for nipple-sparing mastectomy. Breast J. 2011; 17(3): 296–299.
  17. Boneti C, Yuen J, Santiago C, et al. Oncologic safety of nipple skin-sparing or total skin-sparing mastectomies with immediate reconstruction. J Am Coll Surg. 2011; 212(4): 686–93; discussion 693.
  18. Donker M, van Tienhoven G, Straver ME, et al. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol. 2014; 15(12): 1303–1310.
  19. Giuliano AE, Ballman KV, McCall L, et al. Effect of Axillary Dissection vs No Axillary Dissection on 10-Year Overall Survival Among Women With Invasive Breast Cancer and Sentinel Node Metastasis: The ACOSOG Z0011 (Alliance) Randomized Clinical Trial. JAMA. 2017; 318(10): 918–926.
  20. Jung J, Kim BH, Kim J, et al. Validating the ACOSOG Z0011 Trial Result: A Population-Based Study Using the SEER Database. Cancers (Basel). 2020; 12(4).
  21. Offersen BV, Boersma LJ, Kirkove C, et al. ESTRO consensus guideline on target volume delineation for elective radiation therapy of early stage breast cancer, version 1.1. Radiother Oncol. 2016; 118(1): 205–208.
  22. Mutter RW. ESTRO ACROP consensus guideline for target volume delineation in the setting of postmastectomy radiation therapy after implant-based immediate reconstruction for early stage breast cancer. Radiother Oncol. 2019; 141: 329–330.
  23. Tang R, Coopey SB, Colwell AS, et al. Nipple-Sparing Mastectomy in Irradiated Breasts: Selecting Patients to Minimize Complications. Ann Surg Oncol. 2015; 22(10): 3331–3337.
  24. Momoh AO, Ahmed R, Kelley BP, et al. A systematic review of complications of implant-based breast reconstruction with prereconstruction and postreconstruction radiotherapy. Ann Surg Oncol. 2014; 21(1): 118–124.
  25. Lam TC, Hsieh F, Boyages J. The effects of postmastectomy adjuvant radiotherapy on immediate two-stage prosthetic breast reconstruction: a systematic review. Plast Reconstr Surg. 2013; 132(3): 511–518.
  26. Whitfield G, Horan G, Irwin M, et al. Incidence of severe capsular contracture following implant-based immediate breast reconstruction with or without postoperative chest wall radiotherapy using 40 Gray in 15 fractions. Radiother Oncol. 2009; 90(1): 141–147.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Wydawcą serwisu jest VM Media Group sp. z o.o., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl