AI Article Synopsis
- Nipple sparing mastectomy (NSM) is a common procedure for breast cancer patients, but the best way to monitor patients afterward remains unclear.
- A study involving 399 patients from 2007 to 2021 compared those followed by clinical breast exams (CBE) alone to those who also had MRI surveillance, analyzing recurrence rates and survival outcomes.
- Results indicated that while MRI follow-up led to more biopsies, there was no significant difference in overall survival rates between the two groups, suggesting that CBE may be sufficient for postoperative monitoring.
Article Abstract
Background: Nipple sparing mastectomy (NSM) is increasingly being performed for patients with breast cancer. However, optimal postoperative surveillance has not been defined.
Methods: A prospectively maintained database identified patients with in-situ and invasive cancer who underwent NSM between 2007-2021. Clinical data on postoperative breast surveillance and interventions were collected. Patients who had MRI surveillance versus clinical breast exam (CBE) alone were compared with respect to tumor characteristics, recurrence, and survival.
Results: A total of 483 NSMs were performed on 399 patients. 255 (63.9%) patients had invasive ductal carcinoma, 31 (7.8%) invasive lobular carcinoma, 92 (23.1%) DCIS, 6 (1.5%) mixed ductal and lobular carcinoma, 9 (2.3%) others, and 6 (1.5%) unknown. Postoperatively, 265 (66.4%) patients were followed with CBE alone and 134 (33.6%) had surveillance MRIs. At a median follow-up of 33 months, 20 patients (5.0%) developed in-breast recurrence, 6 patients had (1.5%) an axillary recurrence, and 28 with (7.0%) distant recurrence. 14 (53.8%) LRR were detected in the CBE group and 12 (46.2%) were detected in the MRI group (P = .16). Overall survival (OS) was 99%, with no difference in OS between patients who had CBE alone versus MRI (P = .46). MRI was associated with higher biopsy rates compared to CBE alone (15.8% vs. 7.8%, P = .01).
Conclusions: Compared to CBE alone, the use of screening MRI following NSM results in higher rate of biopsy and no difference in overall survival.
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| http://dx.doi.org/10.1016/j.clbc.2024.03.011 | DOI Listing |
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