Assessment of treatment outcomes in patients with breast cancer who underwent mastectomy and breast reconstruction with sparing of the areola-nipple complex – single-center analysis

Purpose Despite significant improvements in early detection of breast cancer, some patients still require mastectomy. One clinical problem currently being analyzed is the possibility of preserving the areola-nipple complex (NAC). The aim of this study was to evaluate the treatment results of breast cancer patients who underwent mastectomy with breast reconstruction with sparing of the NAC. Methods 335 patients who underwent mastectomy with breast reconstruction – with sparing (group I: 300 patients) or removal of NAC (group II: 35 patients), treated in the period 07.2014-06.2020. In the study groups, the length of overall survival (OS) and recurrence-free survival (RFS) were determined – up to 24 months after the end of treatment (short-term results) and up to 80 months (long-term results). The mean follow-up time of patients was 55.6 ± 19.7 months. Results In 50 patients (14.9%), recurrence of neoplastic disease was observed (in group I: 14.7%, in group II: 17.1%; p=0.6972). It was most often a recurrence of cancer in the scar after mastectomy – in 25 patients (respectively: 7.7% vs 5.7%; p=0.6775) or distant metastases – in 16 patients (4.0% vs 11.4%; p=0.051). A total of 10 deaths were observed (6 – 2.0% vs 4 – 11.4%; p=0.0019). A total of 37 patients (10.7% vs 14.3%) required removal of their implant, mainly due to symptoms of infection – in 24 cases (7.3% vs 5.7%). Conclusion Preserving the NAC is a safe therapeutic procedure in patients undergoing mastectomy with the option of reconstructive treatment. In both groups of patients, similar early and late treatment results were obtained.