Nipple-sparing mastectomy in young versus elderly patients

• Published in: Revista Brasileira de ginecologia e obstetrícia Vol. 46
• Main Authors: Frasson, Antônio Luiz, Miranda, Isabela, Vollbrecht, Betina, Malhone, Carolina, Falcone, Ana Beatriz, Barbosa, Fernanda, Cavalcante, Francisco Pimentel, Lichtenfels, Martina
• Format: Journal Article
• Language: English
• Published: Federação Brasileira das Sociedades de Ginecologia e Obstetrícia 23-10-2024
• Subjects: Age factors; Breast neoplasm; Breast neoplasms; Mastectomy; Nipples; OBSTETRICS & GYNECOLOGY; Original; subcutaneous; Young adult; subcutaneous; Young adult; Mastectomy; Breast neoplasms; Age factors; Nipples; Breast neoplasm
• ISSN: 0100-7203; 1806-9339; 1806-9339
• DOI: 10.61622/rbgo/2024rbgo90

In this study, we compared indications and outcomes of 115 young (< 40 years) versus 40 elderly (> 60 years) patients undergoing nipple-sparing mastectomy (NSM) as risk-reducing surgery or for breast cancer (BC) treatment.ObjectiveIn this study, we compared indications and outcomes of 115 young (< 40 years) versus 40 elderly (> 60 years) patients undergoing nipple-sparing mastectomy (NSM) as risk-reducing surgery or for breast cancer (BC) treatment.Between January 2004 and December 2018, young and elderly patients undergoing NSM with complete data from at least 6 months of follow-up were included.MethodsBetween January 2004 and December 2018, young and elderly patients undergoing NSM with complete data from at least 6 months of follow-up were included.BC treatment was the main indication for NSM, observed in 85(73.9%) young versus 33(82.5%) elderly patients, followed by risk-reducing surgery in 30(26.1%) young versus 7(17.5%) elderly patients. Complication rates did not differ between the age groups. At a median follow-up of 43 months, the overall recurrence rate was higher in the younger cohort (p = 0.04). However, when stratified into local, locoregional, contralateral, and distant metastasis, no statistical difference was observed. During the follow-up, only 2(1.7%) young patients died.ResultsBC treatment was the main indication for NSM, observed in 85(73.9%) young versus 33(82.5%) elderly patients, followed by risk-reducing surgery in 30(26.1%) young versus 7(17.5%) elderly patients. Complication rates did not differ between the age groups. At a median follow-up of 43 months, the overall recurrence rate was higher in the younger cohort (p = 0.04). However, when stratified into local, locoregional, contralateral, and distant metastasis, no statistical difference was observed. During the follow-up, only 2(1.7%) young patients died.Our findings elucidate a higher recurrence rate of breast cancer in younger patients undergoing NSM, which may correlate with the fact that age is an independent prognostic factor. High overall survival and low complication rates were evidenced in the two groups showing the safety of NSM for young and elderly patients.ConclusionOur findings elucidate a higher recurrence rate of breast cancer in younger patients undergoing NSM, which may correlate with the fact that age is an independent prognostic factor. High overall survival and low complication rates were evidenced in the two groups showing the safety of NSM for young and elderly patients.