The Journal of Practical Medicine >
Comparison of curative effect and prognosis of preserving nipple and areola in patients with breast cancer by different reconstruction operations
Received date: 2023-06-12
Online published: 2023-12-11
Objective To investigate the safety， efficacy and influencing factors of nipple-sparing mastectomy with different reconstruction methods. Methods A total of 1408 patients who underwent nipple-sparing breast reconstruction in Shanghai Jiaotong University Breast Cancer Database from March 2010 to March 2022 were retrospectively analyzed. According to the reconstruction method， they were divided into one-stage group （n = 876） and two-step group （n = 532）. The cosmetic effect of breast appearance， satisfaction， complications， postoperative recurrence rate and quality of life were compared between the two groups. According to the recurrence， the patients were divided into recurrence group （n = 162） and non-recurrence group （n = 1 246）. Univariate and multivariate Logistic regression analysis were used to analyze the influencing factors of recurrence after nipple-sparing mastectomy. Results The excellent rate of breast appearance and postoperative satisfaction in the one-step group were significantly higher than those in the two-step group （P < 0.05）. There was no significant difference in the incidence of complications and local recurrence between the two groups （P > 0.05）. Six months after surgery， the FACT-B scores of the two groups were higher than those before surgery， and the FACT-B scores of the one-step group were higher than those of the two-step group （P < 0.05）. The proportion of patients older than 35 years old， with invasive cancer of no special type， without endocrine therapy， and without radiotherapy in the recurrence group was significantly higher than that in the non-recurrence group （P < 0.05）. Multivariate Logistic regression analysis showed that age > 35 years old， invasive cancer of no special type， and no adjuvant radiotherapy were independent risk factors for recurrence of reconstruction surgery in patients with nipple-sparing mastectomy for breast cancer （P < 0.05）. Conclusions One-step reconstruction has high application value for the patients undergoing radical mastectomy and is worthy of widespread clinical promotion. Age > 35 years， invasive non-specific cancer， and no adjuvant radiotherapy were independent risk factors for recurrence in patients undergoing radical mastectomy with nipple areola preservation.
Yao MENG , Zhao LIU , Jing ZHANG , Changxiao. ZHAO . Comparison of curative effect and prognosis of preserving nipple and areola in patients with breast cancer by different reconstruction operations[J]. The Journal of Practical Medicine, 2023 , 39(22) : 2903 -2908 . DOI: 10.3969/j.issn.1006-5725.2023.22.008
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