Nipple sparing mastectomy in breast cancer patients and long-term survival outcomes: An analysis of the SEER database

• Published in: PloS one 2017-08, Vol.12 (8), p.e0183448-e0183448
• Main Authors: Li, Mingzhu, Chen, Kai, Liu, Fengtao, Su, Fengxi, Li, Shunrong, Zhu, Liling
• Format: Article
• Language: English
• Subjects: Age; Aged; Analysis; Biology and Life Sciences; Breast cancer; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Breasts; Cancer; Care and treatment; Epidemiology; Epigenetics; Female; Geriatrics; Histology; Hospitals; Humans; Laboratories; Mastectomy; Mastectomy - methods; Medical diagnosis; Medical prognosis; Medicine and Health Sciences; Methods; Middle Aged; Minority & ethnic groups; Nipples - surgery; Older people; Patient outcomes; Patients; People and places; Population; Radiation therapy; Regression analysis; SEER Program; Statistical analysis; Studies; Surveillance; Survival; Survival Analysis; Trends
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0183448

To determine the prevalence of nipple-sparing mastectomy (NSM) and its long-term survival outcomes in breast cancer patients. We used the Surveillance, Epidemiology, and End Results database and identified 2,440 breast cancer patients who received NSM during 1998-2013. We used chi-square and binary logistic regression to identify factors associated with the use of radiotherapy after NSM. We used Kaplan-Meier analysis to estimate cancer-specific survival (CSS) and overall survival (OS). We used the log-rank test and Cox regression to identify factors associated with CSS and OS. The median age of the population was 50 years. There were 725 (29.7%), 1064 (43.6%) and 651 (26.7%) patients who had Tis, T1 and T2-3 disease and 1943 (79.6%), 401 (16.4%) and 96 (3.9%) patients who had N0, N1 and N2-3 disease, respectively. The rates of RT use were 61.4%, 39.6% and 10.9% in patients with N2-3 disease, N1 or T3/N0 disease and Tis/T1-2N0 disease, respectively. Elderly age, African American race, and higher T-stage and N-stage were associated with receiving radiotherapy. For patients diagnosed between 1998-2010 (N = 763), the median follow-up was 69 months. The 5- and 10-yr CSS were 96.9% and 94.9%, respectively. The 5- and 10-yr OS were 94.1% and 88.0%, respectively. Ethnicity, T-stage and N-stage were factors independently associated with CSS, and age and T-stage were factors independently associated with OS. The use of NSM has increased, and it is oncologically safe for breast cancer patients.