Feasibility of Nipple-Sparing Mastectomy with Immediate Breast Reconstruction in Breast Cancer Patients with Tumor-Nipple Distance Less Than 2.0 cm

Background and objective: Debate continues concerning the oncological risk of nipple-sparing mastectomy (NSM) with immediate breast reconstruction (IBR) if the tumor-nipple distance (TND) is less than 2.0 cm. In this retrospective study, we analyzed oncological outcomes after NSM with IBR for the treatment of breast cancer to determine the risk posed by NSM in cases in which magnetic resonance imaging (MRI) showed a TND <2.0 cm but intraoperative frozen biopsy results were negative for tumor cells at the nipple base. Materials and methods: We conducted a retrospective review of patients with breast cancer who underwent NSM with IBR at Samsung Medical Center between 2008 and 2014. Preoperative MRI was done in all cases to define the TND, and frozen biopsy specimens were obtained intraoperatively. Results: Among the 266 NSMs performed, TND was <2.0 cm in 145 cases (54.5 %) and ≥2.0 cm in 121 cases (45.5 %). Median follow-up was 25.6 months. There were no significant differences between the two patient groups with respect to disease-free survival or local recurrence-free survival. Conclusion: Our results suggest that NSM can be a feasible treatment option when the intraoperative frozen biopsy is negative for tumor cells even with a TND <2.0 cm in MRI.