Low Rate of Complications in Nipple-Sparing Mastectomy for Patients with BRCA1 and BRCA2 Mutation

Abstract

Background: To describe the indications and outcomes of BRCA mutation carriers undergoing nipple-sparing mastectomy (NSM). Methods: In this retrospective study, 76 BRCA mutation carriers with no cancer who opted to undergo risk reduction NSM or diagnosed with breast cancer (BC) who opted to undergo therapeutic NSM were included. Results: Indications for NSM: cancer treatment (n = 33), bilateral risk reduction (n = 39) and contralateral prophylactic NSM (n = 4). In a mean follow-up of 45 months (median: 30 months), one patient (2.5%) undergoing risk-reducing NSM developed a new BC. One (3%) local, one (3%) ipsilateral axillary and one (3%) distant recurrence were observed in BC patients. No partial or total nipple necrosis occurred. Conclusion: NSM is safe for reducing the risk of BC development in BRCA mutation carriers and for treating cancer.

Keywords: :

• breast neoplasm
• genetic predisposition to disease
• recurrence
• subcutaneous mastectomy
• surgical procedures

Author contributions

AL Frasson: conceptualization, investigation, methodology, supervision, writing – review and editing; AB Falcone: investigation, methodology, writing – original draft; F Barbosa: investigation, methodology, writing – original draft; ABA Souza: methodology, writing – review and editing; C Malhone: methodology, writing – review and editing; I Miranda: methodology, writing – review and editing; B Vollbrecht: methodology, writing – review and editing; MARM Frasson: methodology, writing – review and editing; L Kobe: methodology, writing – review and editing; M Lichtenfels: formal analysis, writing – original draft.

Financial disclosure

The authors have no financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

Competing interests disclosure

AL Frasson has received a speaker honorarium from Roche, Astrazeneca, Agendia and MSD. ABA Souza has received a speaker honorarium from Astrazeneca, Libbs and MSD. The authors have no other competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript apart from those disclosed.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

All procedures performed in the study were in accordance with the ethical standards by the Institutional Ethics Committee of Pontifical Catholic University of Rio Grande do Sul (PUCRS), Hospital Albert Einstein (HIAE) and the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was waived by the institutional review board for retrospective patients.

Data sharing statement

Data are available upon reasonable request. All data analyzed during this study are included in this article. Further inquiries can be directed to the corresponding author.