For patients with low-risk disease, LRFS and LRRFS were not significantly different for mastectomy techniques. For this patient population, SSM and NSM appear to be safe and equivalent to TM at 8 years of follow-up.
Zachary Hopkins, Jonathan Frandsen, MD, Katherine E. Poruk, MD, Jayant Agarwal, MD, Matthew Poppe, MD; University of Utah School of Medicine; Huntsman Cancer Hospital; The Johns Hopkins Hospital
INTRODUCTION: Skin-sparing mastectomy (SSM) and nipple-sparing mastectomy (NSM) are gaining popularity for their potential for better cosmesis and patient satisfaction. Evidence for the oncologic safety of these procedures is still evolving. In this study, we evaluated local recurrence–free survival (LRFS) and locoregional recurrence–free survival (LRRFS) for women at our institution who received NSM and SSM as compared with patients receiving traditional non–skin-sparing or nipple-sparing mastectomies (TMs).
METHODS: The tumor registry from the University of Utah was utilized for this review. From 2005 to 2014, women with T1–2, N0, or M0 disease who did not receive radiation were included in the analysis. Patients were separated into one of three cohorts based on mastectomy type. Kaplan-Meier survival estimates were used to estimate LRFS and LRRFS. Cox proportional hazards analysis was used to calculate risk factors contributing to these outcomes.
RESULTS: We identified 457 patients who met our criteria. At 8 years, LRFS was 98.7% for TM, 100.0% for NSM, and 96.9% for SSM. Log-rank analysis showed no significant difference in LRFS or LRRFS between the three groups (P = .60). At 8 years, LRRFS was 96.9% for TM, 92.6% for NSM, and 91.6% for SSM, with no significant differences seen among these groups (P = .60). In univariate analyses, only tumor size was a significant risk factor for LR (hazard ratio, 2.33 [95% CI, 1.07–5.09]). Age at diagnosis, margin status, receipt of chemotherapy or hormone therapy, and grade were all nonsignificant.
CONCLUSIONS: For patients with low-risk disease, LRFS and LRRFS were not significantly different for mastectomy techniques. For this patient population, SSM and NSM appear to be safe and equivalent to TM at 8 years of follow-up.
Proceedings of the 98th Annual Meeting of the American Radium Society - americanradiumsociety.org