Evidence based outcomes of the American Society of Breast Surgeons Nipple Sparing Mastectomy Registry

Sunny D. Mitchell, Shawna C. Willey, Peter Beitsch, Sheldon M. Feldman

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: The American Society of Breast Surgeons (ASBrS) Nipple Sparing Mastectomy Registry (NSMR) is a prospective, non-randomized, IRB approved, multi-institutional registry. The purpose of this Registry is to provide a large, prospective, non-randomized database of patient characteristics, tumor characteristics, surgical technique, and outcome (both aesthetic and oncologic) of the nipple sparing mastectomy (NSM). Methods: Data is entered into the ASBrS NSMR, housed within the Mastery of Surgery Program, after patients consent to participation. Each investigator routinely offers NSM in their practice has obtained IRB approval and completed forms of agreement to participate in the ASBrS NSMR. Results: This data set represents a total of 1,935 NSMs performed on 1,170 patients by 98 investigators from 70 institutions/sites. Of the 1,935 NSMs: 833 were performed for an indication of cancer [594 invasive carcinoma and 239 for ductal carcinoma in situ (DCIS)] and 1,102 were prophylactic. Of the 1,170 total patients, 352 underwent a unilateral and 818 underwent a bilateral NSM. Recurrence at a mean follow-up of 31 months/median follow-up of 27 months, with a range of 9.7 to 58.3 months since surgery was 1.4% with no recurrences at the nipple or nipple areola complex (NAC). Cancer occurrence (0.3%) also did not involve the nipple/NAC. Overall patient satisfaction of excellent/good: 94.9% and overall cosmesis (surgeon rated) of excellent/good was 96.4%. Overall infection rates included flap infection of 4.4%, NAC complication rate of 4.5% (defined as necrosis/other or ischemia/epidermolysis requiring surgery), and a 10% rate of NAC epidermolysis with full recovery. Conclusions: NSMs were performed on breasts with a variety of sizes and degrees of ptosis, via multiple incisions, dissection and reconstruction techniques with low complication rates and high patient satisfaction and surgeon rated cosmesis.

Original languageEnglish (US)
Pages (from-to)247-257
Number of pages11
JournalGland Surgery
Volume7
Issue number3
DOIs
StatePublished - Jun 1 2018

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Nipples
Mastectomy
Registries
Breast
Research Ethics Committees
Patient Satisfaction
Research Personnel
Recurrence
Neoplasms
Carcinoma, Intraductal, Noninfiltrating
Infection
Esthetics

Keywords

  • Nipple sparing mastectomy (NSM)
  • Outcome data

ASJC Scopus subject areas

  • Surgery

Cite this

Evidence based outcomes of the American Society of Breast Surgeons Nipple Sparing Mastectomy Registry. / Mitchell, Sunny D.; Willey, Shawna C.; Beitsch, Peter; Feldman, Sheldon M.

In: Gland Surgery, Vol. 7, No. 3, 01.06.2018, p. 247-257.

Research output: Contribution to journalArticle

Mitchell, Sunny D. ; Willey, Shawna C. ; Beitsch, Peter ; Feldman, Sheldon M. / Evidence based outcomes of the American Society of Breast Surgeons Nipple Sparing Mastectomy Registry. In: Gland Surgery. 2018 ; Vol. 7, No. 3. pp. 247-257.
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abstract = "Background: The American Society of Breast Surgeons (ASBrS) Nipple Sparing Mastectomy Registry (NSMR) is a prospective, non-randomized, IRB approved, multi-institutional registry. The purpose of this Registry is to provide a large, prospective, non-randomized database of patient characteristics, tumor characteristics, surgical technique, and outcome (both aesthetic and oncologic) of the nipple sparing mastectomy (NSM). Methods: Data is entered into the ASBrS NSMR, housed within the Mastery of Surgery Program, after patients consent to participation. Each investigator routinely offers NSM in their practice has obtained IRB approval and completed forms of agreement to participate in the ASBrS NSMR. Results: This data set represents a total of 1,935 NSMs performed on 1,170 patients by 98 investigators from 70 institutions/sites. Of the 1,935 NSMs: 833 were performed for an indication of cancer [594 invasive carcinoma and 239 for ductal carcinoma in situ (DCIS)] and 1,102 were prophylactic. Of the 1,170 total patients, 352 underwent a unilateral and 818 underwent a bilateral NSM. Recurrence at a mean follow-up of 31 months/median follow-up of 27 months, with a range of 9.7 to 58.3 months since surgery was 1.4{\%} with no recurrences at the nipple or nipple areola complex (NAC). Cancer occurrence (0.3{\%}) also did not involve the nipple/NAC. Overall patient satisfaction of excellent/good: 94.9{\%} and overall cosmesis (surgeon rated) of excellent/good was 96.4{\%}. Overall infection rates included flap infection of 4.4{\%}, NAC complication rate of 4.5{\%} (defined as necrosis/other or ischemia/epidermolysis requiring surgery), and a 10{\%} rate of NAC epidermolysis with full recovery. Conclusions: NSMs were performed on breasts with a variety of sizes and degrees of ptosis, via multiple incisions, dissection and reconstruction techniques with low complication rates and high patient satisfaction and surgeon rated cosmesis.",
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