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

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 Thepatientswere followedupfor amean time of132months since thefirst 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 NSMmay be considered after IBTR for patients who did not want to undergo total mastectomy.

摘要
目的 目前鲜有研究分析挽救性保留乳头乳房切除术（NSM）用于局部复发治疗的安全性。本研究针对符合乳房切除术指征、且选择行NSM治疗同侧乳腺肿瘤复发（IBTR）的患者，评估其治疗结局。
方法 2001年1月至2018年12月期间，本研究纳入24名因保乳手术后局部复发而行NSM的女性患者进行分析。
结果 所有患者自首次手术起的平均随访时长为132个月。NSM术后，5名（20.8%）患者被诊断为局部复发，仅1名（4.2%）患者死亡。患者术后出现乳头部分坏死的比例为4.8%（2例），乳头完全坏死的比例为2.4%（1例）。
结论 在自首次手术起的长期随访中，尽管接受挽救性NSM治疗的IBTR患者局部复发率较高，但并发症发生率较低且生存预后良好。本研究表明，对于不愿接受全乳房切除术的IBTR患者，可考虑行NSM作为挽救治疗方案。