Oncologic Safety and Outcomes in Patients Undergoing Nipple-Sparing Mastectomy

Abstract Introduction Nipple sparing mastectomy (NSM) is an alternative to skin sparing mastectomy in appropriately selected patients. The aim of this study was to review our experience with NSM and to evaluate for oncologic safety. Methods Patients who underwent NSM at our institution from September 2008 through August 2017 were identified after IRB approval. Data included patient age, tobacco use, tumor size, hormone receptor status, lymph node status, radiation and chemotherapy use, incision type, and reconstruction type. Statistical analyses were performed using ANOVA and chi-squared tests. Results 322 patients underwent 588 NSM (83% bilateral, 17% unilateral), including 399 (68%) for malignancy [Stage 0 (27%), I (44%), II (25%) and III (4%)]. The overall rate of wound complications was 18.9%. Tobacco use increased complications (37.5% versus 16.3%, p Conclusion Most NSM performed at our institution are in patients with malignancy. The oncologic safety is confirmed by the low locoregional recurrence rate. Tobacco use and adjuvant radiation therapy remain the most significant risk factors for complications, highlighting the need for careful patient selection and patient counseling regarding modifiable risk factors and expected outcomes.