Equivalent survival after nipple-sparing compared to non-nipple-sparing mastectomy: data from California, 1988–2013

Details

• Alternative Title:
  Breast Cancer Res Treat
• Personal Author:
  Kurian, Allison W. ; Canchola, Alison J. ; Gomez, Scarlett L. ; Clarke, Christina A.
• Description:
  Purpose ; Nipple-sparing mastectomy, which may improve cosmesis, body image, and sexual function in comparison to non-nipple-sparing mastectomy, is increasingly used to treat early-stage breast cancer; however, long-term survival data are lacking. We evaluated survival after nipple-sparing mastectomy versus non-nipple-sparing mastectomy in a population-based cancer registry. ; Methods ; We conducted an observational study using the California Cancer Registry, considering all stage 0–III breast cancers diagnosed in California from 1988 to 2013. We compared breast cancer-specific and overall survival time after nipple-sparing versus non-nipple-sparing mastectomy, using multivariable analysis. ; Results ; Among 157,592 stage 0–III female breast cancer patients treated with unilateral mastectomy from 1988–2013, 993 (0.6 %) were reported as having nipple-sparing and 156,599 (99.4 %) non-nipple-sparing mastectomies; median follow-up was 7.9 years. The proportion of mastectomies that were nipple-sparing increased over time (1988, 0.2 %; 2013, 5.1 %) and with neighborhood socioeconomic status, and decreased with age and stage. On multivariable analysis, nipple-sparing mastectomy was associated with a lower risk of breast cancer-specific mortality compared to non-nipple-sparing mastectomy hazard ratio (HR) 0.71, 95 % confidence interval (CI) 0.51–0.98. However, when restricting to diagnoses 1996 or later and adjusting for a larger set of covariates, risk was attenuated (HR 0.86, 95 % CI 0.52–1.42). ; Conclusions ; Among California breast cancer patients diagnosed from 1988–2013, nipple-sparing mastectomy was not associated with worse survival than non-nipple-sparing mastectomy. These results may inform the decisions of patients and doctors deliberating between these surgical approaches for breast cancer treatment.
• Subjects:
  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms
  • Ethnicity
  • Female
  • Follow-Up Studies
  • Humans
  • Mastectomy, Subcutaneous
  • Middle Aged
  More +
• Source:
  Breast Cancer Res Treat. 160(2):333-338.
• Pubmed ID:
  27665587
• Pubmed Central ID:
  PMC5759961
• Document Type:
  Journal Article
• Funding:
  HHSN261201000140C/CA/NCI NIH HHS/United States ; U58 DP000807/DP/NCCDPHP CDC HHS/United States ; HHSN261201000035C/CA/NCI NIH HHS/United States ; P30 CA124435/CA/NCI NIH HHS/United States ; HHSN261201000034C/CA/NCI NIH HHS/United States ; N01 PC035137/PC/NCI NIH HHS/United States
• Place as Subject:
  California
• Volume:
  160
• Issue:
  2
• Download URL:
  https://stacks.cdc.gov/view/cdc/50782/cdc_50782_DS1.pdf
• File Type:
  [PDF - 76.23 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:bdd22d395f5f5ea117b0c3fb0e1a8a23aea91a448dc199a69f375202b49cbee9