Nipple-areolar complex (NAC) or skin flap ischemia necrosis post nipple-sparing mastectomy (NSM)—analysis of clinicopathologic factors and breast magnetic resonance imaging (MRI) features

World Journal of Surgical Oncology

Research

Wen-Pin Kao¹  Yi-Yuan Lee²  Chiung-Ying Liao³  Dar-Ren Chen⁴  Shou-Tung Chen⁴  Tsung-Lin Tsai⁵  Hung-Wen Lai⁶  Wen-Pei Wu⁷  Yuan-Chieh Lai⁸ 

[1] Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan;Division of Plastic Surgery, Department of Surgery, Changhua Christian Hospital, 500, Changhua, Taiwan;Department of Public Health, China Medical University, Taichung, Taiwan;Department of Radiology, Changhua Christian Hospital, Changhua, Taiwan;Division of General Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan;Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan;Division of General Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan;School of Medicine, Chung Shan Medical University, Taichung, Taiwan;Endoscopic & Oncoplastic Breast Surgery Center, Changhua Christian Hospital, Changhua, Taiwan;Division of General Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan;Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan;Minimal Invasive Surgery Research Center, Changhua Christian Hospital, Changhua, Taiwan;Kaohsiung Medical University, Kaohsiung, Taiwan;Division of Breast Surgery, Yuanlin Christian Hospital, Yuanlin, Taiwan;School of Medicine, Chung Shan Medical University, Taichung, Taiwan;School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Kaohsiung Medical University, Kaohsiung, Taiwan;School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Department of Radiology, Changhua Christian Hospital, Changhua, Taiwan;School of Medicine, Chung Shan Medical University, Taichung, Taiwan;

关键词: Nipple-sparing mastectomy (NSM);    Nipple-areola complex (NAC);    MRI;    Ischemia necrosis;    Robotic-assisted nipple-sparing mastectomy (R-NSM);    Endoscopic-assisted nipple-sparing mastectomy (E-NSM);    Skin flap;   

DOI  :  10.1186/s12957-023-02898-x

 received in 2022-08-25, accepted in 2023-01-10,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe purpose of this study is to identify clinicopathologic factors and/or preoperative MRI vascular patterns in the prediction of ischemia necrosis of the nipple-areola complex (NAC) or skin flap post nipple-sparing mastectomy (NSM).MethodsWe performed a retrospective analysis of 441 NSM procedures from January 2011 to September 2021 from the breast cancer database at our institution. The ischemia necrosis of NAC or skin flap was evaluated in correlation with clinicopathologic factors and types of skin incision. Patients who received NSM with preoperative MRI evaluation were further evaluated for the relationship between vascular pattern and the impact on ischemia necrosis of NAC or skin flap.ResultsA total of 441 cases with NSM were enrolled in the current study, and the mean age of the cases was 49.1 ± 9.8 years old. A total of 41 (9.3%) NSM procedures were found to have NAC ischemia/necrosis. Risk factors were evaluated of which old age, large mastectomy specimen weight (> 450 g), and peri-areola incision were identified as predictors of NAC necrosis. Two-hundred seventy NSM procedures also received preoperative MRI, and the blood supply pattern was 18% single-vessel type and 82% double-vessel pattern. There were no correlations between MRI blood supply patterns or types of skin flap incisions with ischemia necrosis of NAC. There were also no correlations between blood loss and the pattern or size of the blood vessel.ConclusionFactors such as the type of skin incision, age, and size of mastectomy weight played an important role in determining ischemia necrosis of NAC; however, MRI vascular (single or dual vessel supply) pattern was not a significant predictive factor.

【 授权许可】

CC BY   
© The Author(s) 2023

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