Technical Feasibility and Early Postoperative Complications after Nipple-Sparing Mastectomy through Semi-Periareolar Incision in Patients with Breast Cancer

Le résumé fourni par la source

Purpose: This study aimed to assess the technical feasibility of nipple-sparing mastectomy (NSM) through a semi-periareolar incision in patients with breast cancer with a focus on nipple-areolar complex (NAC) necrosis within 30 postoperative days in relation to patient-tumor surgery parameters and the dominant blood supply to the NAC on breast magnetic resonance imaging. Methods: NSM using a semi-periareolar incision was performed on 54 breasts of 46 patients who underwent immediate breast reconstructions between March 2020 and June 2024. Descriptive statistics were summarized retrospectively, and risk factors for NAC necrosis were analyzed, including whether the NAC was supplied by an internal mammary artery perforator (IMP) or not (non-IMP). Results: The mean patient age was 45.9 years, and 21.7% had comorbidities. The average times for NSM and reconstruction, mostly direct-to-implant insertions, were 124 and 68 minutes, respectively. The mean hospitalization duration was 7 days, and the drains were removed after an average of 13 days. Early complications occurred in 19 breasts (35.2%), including 10 (18.5%) cases of NAC necrosis that required reoperation. No implant loss was observed on postoperative day 30. Although statistically significant risk factors for NAC necrosis were not identified, greater surgical experience was associated with fewer cases of NAC necrosis. Dominant IMPs were detected in 38 (70.4%) cases, and no statistically significant difference was found in the revision rate according to IMP flow. Conclusion: NSM through a semi-periareolar incision is technically feasible. Considering the clinical and radiological risk factors for developing NAC ischemia or necrosis, careful patient selection and sufficient surgical experience are prerequisites for successful surgery without early complications.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.