PMID- 27600636
OWN - NLM
STAT- MEDLINE
DCOM- 20170713
LR  - 20170713
IS  - 1880-4233 (Electronic)
IS  - 1340-6868 (Linking)
VI  - 24
IP  - 3
DP  - 2017 May
TI  - Current trends and outcomes of breast reconstruction following nipple-sparing 
      mastectomy: results from a national multicentric registry with 1006 cases over a 
      6-year period.
PG  - 451-457
LID - 10.1007/s12282-016-0726-z [doi]
AB  - BACKGROUND: Reconstruction options following nipple-sparing mastectomy (NSM) are 
      diverse and not yet investigated with level IA evidence. The analysis of surgical 
      and oncological outcomes of NSM from the Italian National Registry shows its 
      safety and wide acceptance both for prophylactic and therapeutic cases. A further 
      in-depth analysis of the reconstructive approaches with their trend over time and 
      their failures is the aim of this study. METHODS: Data extraction from the 
      National Database was performed restricting cases to the 2009-2014 period. 
      Different reconstruction procedures were analyzed in terms of their distribution 
      over time and with respect to specific indications. A 1-year minimum follow-up 
      was conducted to assess reconstructive unsuccessful events. Univariate and 
      multivariate analyses were performed to investigate the causes of both prosthetic 
      and autologous failures. RESULTS: 913 patients, for a total of 1006 procedures, 
      are included in the analysis. A prosthetic only reconstruction is accomplished in 
      92.2 % of cases, while pure autologous tissues are employed in 4.2 % and a hybrid 
      (prosthetic plus autologous) in 3.6 %. Direct-to-implant (DTI) reaches 48.7 % of 
      all reconstructions in the year 2014. Prophylactic NSMs have a DTI reconstruction 
      in 35.6 % of cases and an autologous tissue flap in 12.9 % of cases. Failures are 
      2.7 % overall: 0 % in pure autologous flaps and 9.1 % in hybrid cases. 
      Significant risk factors for failures are diabetes and the previous radiation 
      therapy on the operated breast. CONCLUSIONS: Reconstruction following NSM is 
      mostly prosthetic in Italy, with DTI gaining large acceptance over time. Failures 
      are low and occurring in diabetic and irradiated patients at the multivariate 
      analysis.
FAU - Casella, Donato
AU  - Casella D
AD  - Oncologic and Reconstructive Surgery, Breast Unit Surgery, Careggi University 
      Hospital, L.go Brambilla 3, 50134, Florence, Italy.
FAU - Calabrese, Claudio
AU  - Calabrese C
AD  - Oncologic and Reconstructive Surgery, Breast Unit Surgery, Careggi University 
      Hospital, L.go Brambilla 3, 50134, Florence, Italy.
FAU - Orzalesi, Lorenzo
AU  - Orzalesi L
AD  - Oncologic and Reconstructive Surgery, Breast Unit Surgery, Careggi University 
      Hospital, L.go Brambilla 3, 50134, Florence, Italy.
FAU - Gaggelli, Ilaria
AU  - Gaggelli I
AD  - Oncologic and Reconstructive Surgery, Breast Unit Surgery, Careggi University 
      Hospital, L.go Brambilla 3, 50134, Florence, Italy.
FAU - Cecconi, Lorenzo
AU  - Cecconi L
AD  - Statistics, Department of Statistics, Informatics and Application "G.Parenti", 
      University of Florence, Viale Morgagni 59, 50134, Florence, Italy.
FAU - Santi, Caterina
AU  - Santi C
AD  - Oncologic and Reconstructive Surgery, Breast Unit Surgery, Careggi University 
      Hospital, L.go Brambilla 3, 50134, Florence, Italy.
FAU - Murgo, Roberto
AU  - Murgo R
AD  - Breast Unit Surgery, San Giovanni Rotondo Hospital, Viale Cappuccini 1, 71013, 
      S.Giovanni Rotondo, Foggia, Italy.
FAU - Rinaldi, Stefano
AU  - Rinaldi S
AD  - Breast Unit Surgery, San Paolo Hospital, Via Capo Scardicchio 92, 70123, Bari, 
      Italy.
FAU - Regolo, Lea
AU  - Regolo L
AD  - Breast Unit Surgery, Maugeri Hospital, Via Maugeri 10, 27100, Pavia, Italy.
FAU - Amanti, Claudio
AU  - Amanti C
AD  - Breast Unit Surgery, Sant'Andrea Hospital, Via di Grottarossa 1035, 00189, Rome, 
      Italy.
FAU - Roncella, Manuela
AU  - Roncella M
AD  - Breast Unit Surgery, Cisanello Hospital, Via Roma 67, 56123, Pisa, Italy.
FAU - Serra, Margherita
AU  - Serra M
AD  - Breast Unit Surgery, Sant'Orsola Hospital, Via Massarenti 9, 40138, Bologna, 
      Italy.
FAU - Meneghini, Graziano
AU  - Meneghini G
AD  - Breast Unit, Montecchio Maggiore Hospital, Via Ca' Rotte 7, 36075, Montecchio 
      Maggiore, Vicenza, Italy.
FAU - Bortolini, Massimiliano
AU  - Bortolini M
AD  - Breast Unit Surgery, Valdese Hospital, Via Pellico 19, 10125, Turin, Italy.
FAU - Altomare, Vittorio
AU  - Altomare V
AD  - Breast Unit, Campus Biomedico Hospital, Via Alvaro del Portillo 200, 00128, Rome, 
      Italy.
FAU - Cabula, Carlo
AU  - Cabula C
AD  - Breast Unit Surgery, Businco Hospital, Via Jenner 1, 09127, Cagliari, Italy.
FAU - Catalano, Francesca
AU  - Catalano F
AD  - Breast Unit, Cannizzaro Hospital, Via Messina 829, 95126, Catania, Italy.
FAU - Cirilli, Alfredo
AU  - Cirilli A
AD  - Breast Unit Surgery, Policlinico Hospital, P.zza Giulio Cesare 11, Bari, Italy.
FAU - Caruso, Francesco
AU  - Caruso F
AD  - Breast Unit Surgery, Humanitas Hospital, Via Vittorio Emanuele da Bormida 64, 
      95126, Catania, Italy.
FAU - Lazzaretti, Maria Grazia
AU  - Lazzaretti MG
AD  - Breast Unit Surgery, Ramazzini Hospital, Via Molinari 2, 41012, Carpi (Modena), 
      Italy.
FAU - Meattini, Icro
AU  - Meattini I
AD  - Radiation-Oncology, Oncology Department, Careggi University Hospital, L.go 
      Brambilla 3, 50134, Florence, Italy.
FAU - Livi, Lorenzo
AU  - Livi L
AD  - Radiation-Oncology, Oncology Department, Careggi University Hospital, L.go 
      Brambilla 3, 50134, Florence, Italy.
FAU - Cataliotti, Luigi
AU  - Cataliotti L
AD  - President European Breast Centres Certification, President Senonetwork Italia 
      Onlus, Florence, Italy.
FAU - Bernini, Marco
AU  - Bernini M
AUID- ORCID: 0000-0002-9598-4860
AD  - Oncologic and Reconstructive Surgery, Breast Unit Surgery, Careggi University 
      Hospital, L.go Brambilla 3, 50134, Florence, Italy. marco.bern@tin.it.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20160906
PL  - Japan
TA  - Breast Cancer
JT  - Breast cancer (Tokyo, Japan)
JID - 100888201
SB  - IM
MH  - Breast Implants
MH  - Breast Neoplasms/*surgery
MH  - Female
MH  - Humans
MH  - Italy
MH  - Mammaplasty/*methods/*trends
MH  - Mastectomy, Subcutaneous/methods/*trends
MH  - Nipples/surgery
MH  - Registries
MH  - Surgical Flaps
MH  - Treatment Failure
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Autologous breast reconstruction
OT  - Breast reconstruction
OT  - Direct-to-implant
OT  - Nipple-sparing mastectomy
OT  - Tissue expander
EDAT- 2016/09/08 06:00
MHDA- 2017/07/14 06:00
CRDT- 2016/09/08 06:00
PHST- 2016/06/11 00:00 [received]
PHST- 2016/08/28 00:00 [accepted]
PHST- 2016/09/08 06:00 [pubmed]
PHST- 2017/07/14 06:00 [medline]
PHST- 2016/09/08 06:00 [entrez]
AID - 10.1007/s12282-016-0726-z [pii]
AID - 10.1007/s12282-016-0726-z [doi]
PST - ppublish
SO  - Breast Cancer. 2017 May;24(3):451-457. doi: 10.1007/s12282-016-0726-z. Epub 2016 
      Sep 6.