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CC BY 4.0 · Rev Bras Ginecol Obstet 2022; 44(05): 489-496
DOI: 10.1055/s-0042-1743098
Original Article
Mastology

Salvage Nipple-sparing Mastectomy for Patients with Breast Cancer Recurrence: A Case Series of Brazilian Patients

Mastectomia preservadora de mamilo para pacientes com recidiva de câncer de mama: Uma série de casos de pacientes brasileiras
Antônio Luiz Frasson 
1   Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
,
Martina Lichtenfels 
2   Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Fernanda Barbosa 
1   Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
,
Alessandra Borba Anton de Souza 
2   Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Ana Beatriz Falcone 
1   Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
,
Isabela Miranda 
2   Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Betina Vollbrecht 
2   Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Carolina Malhone 
1   Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
,
José Yoshikazu Tariki 
1   Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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Abstract

Objective Few studies analyzed the safety of salvage nipple-sparing mastectomy (NSM) for local relapse treatment. We evaluated the outcomes of patients with indications for mastectomy who chose to undergo NSM for ipsilateral breast tumor recurrence (IBTR).

Methods Between January 2001 and December 2018, we evaluated 24 women who underwent NSM for local relapse after conservative surgery.

Results The patients were followed up for a mean time of 132 months since the first surgery. After the NSM, 5 (20.8%) patients were diagnosed with local recurrence and only 1 (4.2%) patient died. The patients presented 4.8% (2) of partial and 2.4% (1) of total nipple necrosis.

Conclusion In this long-term follow-up since the first surgery, we observed low rates of complication and good survival, although associated with high local recurrence in patients diagnosed with IBTR undergoing NSM as salvage surgery. We demonstrated that NSM may be considered after IBTR for patients who did not want to undergo total mastectomy.

Resumo

Objetivo Há poucos estudos sobre a segurança de se realizar adenomastectomia (nipple-sparing mastectomy, NSM, em inglês) para tratamento de recidiva local. O objetivo deste estudo foi avaliar os resultados de pacientes com indicação para mastectomia que optaram por se submeter a NSM para o tratamento de recorrência local.

Métodos Foram analisadas 24 pacientes submetidas a NSM para tratamento de recidiva local após tratamento conservador entre janeiro de 2001 e dezembro de 2018.

Resultados As pacientes foram acompanhadas por um período médio de 132 meses a partir da primeira cirurgia. Após a NSM, 5 (20,8%) pacientes foram diagnosticadas com recorrência local, e apenas 1 paciente foi a óbito. As pacientes apresentaram 4,8% de necrose parcial e 2,4% de necrose total do mamilo.

Conclusão Em um longo período de acompanhamento desde a primeira cirurgia, foram observadas baixas taxas de complicação pós-operatória e boa sobrevida, porém, associadas com uma alta taxa de recorrência local em pacientes submetidas a NSM para tratamento de recidiva local após cirurgia conservadora. Neste estudo, demonstrou-se que a NSM pode ser considerada uma opção cirúrgica para pacientes que não querem se submeter a mastectomia total.

Keywords

neoplasm recurrence - subcutaneous mastectomy - segmental mastectomy

Palavras-chave

neoplasias da mama - mastectomia subcutânea - mastectomia segmental


Publication History

Received: 13 July 2021

Accepted: 18 November 2021

Article published online:
24 February 2022

© 2022. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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