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Equivalent survival after nipple-sparing compared to non-nipple-sparing mastectomy: data from California, 1988–2013
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Sep 24 2016
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Source: Breast Cancer Res Treat. 160(2):333-338.
[PDF-76.23 KB]
Details:
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Alternative Title:Breast Cancer Res Treat
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Personal Author:
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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.
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Pubmed ID:27665587
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Pubmed Central ID:PMC5759961
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