Dados do Trabalho

Título

ADENOMASTECTOMIA COM RECONSTRUÇAO IMEDIATA COM IMPLANTES EM PACIENTES COM CARCINOMA DUCTAL IN SITU

Título em Inglês

NIPPLE-SPARING MASTECTOMY WITH IMMEDIATE IMPLANT-BASED RECONSTRUCTION FOR PATIENTS WITH PURE DUCTAL CARCINOMA IN SITU TUMORS

Introdução

The presence of extensive intraductal component is strongly associated to the increasing risk of nipple-areola complex (NAC) relapse. Most of the studies focusing on the outcomes of patients diagnosed with pure ductal carcinoma in situ (DCIS) who underwent nipple-sparing mastectomy (NSM) available in the literature performed immediate breast reconstruction using prosthetic implant (saline-filled implant or tissue expander) and autologous tissue flap.

Objetivos

The aim of our study was to evaluate the outcomes of patients diagnosed with DCIS who underwent NSM with immediate implant-based breast reconstruction.

Métodos

We retrospectively analyzed complication rates and oncological safety of 67 breast cancer patients diagnosed with pure DCIS who underwent NSM with immediate implant-based breast reconstruction between 2004 and 2018. Patients that underwent risk reduction NSM with accidental finding of DCIS were included in the study and all patients were operated by the lead author. Tumor-nipple distance and tumor size were not exclusion criteria.

Resultados

The indications for NSM were risk reduction breast surgery with accidental finding of DCIS (n = 4, 6%), multifocal disease (n=16, 23.9%), compromised margins after breast-conserving surgery (n=11, 16.4%), tumors > 40 mm (n=16, 23.9%) and unfavorable relationships between tumor size and breast size or patient preference (n=20, 29.8%). The mean age of the patients was 46.8 years (range 30-75). Of the 69 procedures performed for DCIS, a total of 3 complications occurred, including two hematomas (2.9%) and one partial nipple necrosis (1.4%). After a mean follow-up of 60 months (range 3-183 months) the local recurrence rate was 8.9%. We observed a tendency of tumor multifocality being a risk factor for local relapse. The disease-free survival (DFS) rate was 90% and none of the patients died during the follow-up.

Conclusões

Despite the local recurrence rate, we showed that NSM with immediate breast reconstruction using prosthetic implant is a feasible surgical approach with low complication rates and good disease-free and overall survival rates for patients with pure DCIS when BCS is not an option.

Palavras Chave

Breast cancer; intraductal noninfiltrating carcinoma; subcutaneous mastectomy

Área

TREATMENT - DCIS