Nipple-sparing Mastectomy with Immediate Implant-based Reconstruction for Patients with Pure Ductal Carcinoma in Situ

Abstract Objective The presence of an extensive intraductal component is associated to an increasing risk of relapse in the nipple-areola complex. The aim of the present study was to evaluate the outcomes of patients diagnosed with ductal carcinoma in situ (DCIS) who underwent nipple-sparing mastectomy (NSM) with immediate breast reconstruction using silicone implants. Methods We retrospectively analyzed the postoperative complications and oncological safety of 67 breast cancer patients diagnosed with pure DCIS who underwent NSM with immediate breast reconstruction using silicone implants between 2004 and 2018. Results Among the 127 NSM procedures performed, 2 hematomas (1.5%) and 1 partial nipple necrosis (0.7%) were observed. After a mean follow-up of 60months, the local recurrence rate was of 8.9%, the disease-free survival rate was of 90%, and 1 of the patients died. Conclusion Despite the local recurrence rate, we showed that NSM with immediate breast reconstruction using silicone implants is a feasible surgical approach, with a low rate of complications and high survival rates for patients with a diagnosis of pure DCIS when breast-conserving surgery is not an option.

摘要
研究背景与目的：广泛导管内成分的存在与乳头乳晕复合体复发风险升高相关。本研究旨在评估确诊为导管原位癌（ductal carcinoma in situ, DCIS）且接受保留乳头乳晕乳房切除术（nipple-sparing mastectomy, NSM）联合硅胶假体即刻乳房重建的患者的预后结局。
方法：本研究回顾性分析了2004年至2018年间，67例确诊为纯导管原位癌且接受保留乳头乳晕乳房切除术联合硅胶假体即刻乳房重建的乳腺癌患者的术后并发症与肿瘤学安全性。
结果：在共计完成的127例保留乳头乳晕乳房切除术中，共观察到2例血肿（占比1.5%）及1例乳头部分坏死（占比0.7%）。经平均60个月的随访后，患者局部复发率为8.9%，无病生存率为90%，仅1例患者死亡。
结论：尽管存在局部复发风险，本研究结果表明，对于无法接受保乳手术的纯导管原位癌患者而言，保留乳头乳晕乳房切除术联合硅胶假体即刻乳房重建是一种可行的手术方案，其并发症发生率较低且患者生存率较高。