<< Back to the abstract archive
Demographics and postoperative outcomes for skin-sparing and nipple-sparing mastectomy in patients undergoing deep inferior epigastric perforator (DIEP) flap breast reconstruction
Madeleine M. Blazel BS, Shannon S. Wu BA, Rachel E. Schafer BA, Priya Shukla BS, Steven Bernard MD, Graham Schwarz MD, Risal Djohan MD, Raffi Gurunian MD, Sarah N. Bishop MD
Hospital/research center
Cleveland Clinic Foundation
2023-01-29
Presenter: Madeleine Blazel
Affidavit:
I agree with the breakdown of work as shown below
Director Name: Steven Bernard
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Purpose: Mastectomy is performed prior to or concurrently with DIEP reconstruction. However, complication rates of nipple-sparing mastectomy (NSM) versus skin-sparing mastectomy (SSM) are not well-understood.
Methods: This retrospective study included patients who underwent SSM or NSM with DIEP between January 2019-July 2022 at an academic institution. Variables were compared using Wilcoxon rank-sum, Chi-square, and Fisher's exact tests.
Results: Of 271 patients, 113 (41.7%) underwent NSM and 158 (58.3%) underwent SSM. Although BMI, smoking, and diabetes were not different, the NSM cohort was younger (48.7 vs 52.0 years, p=0.015), had smaller sternal notch-to-nipple distances (25 vs. 26 cm, p<0.001), and underwent longer operations (10.8 vs. 9.0 hours, p<0.001) than the SSM cohort. NSM patients were more likely to undergo immediate reconstruction (50.5% vs. 30.6% delayed, p=0.001). They were less likely to have concurrent breast cancer (73.5% vs. 89.2%, p<0.001), but more likely to have earlier cancer staging (72.3% vs. 51.1% stage 1, p=0.002) and a BRCA1/2 mutation (28.3% vs. 13.3%, p=0.002). While flap takebacks, hematoma, and venous thromboembolism were not different, the NSM cohort had higher 30-day complications (22.1% vs. 12.7%, p=0.039) and infections (5.31% vs. 0%, p=0.005).
Conclusions: NSM patients were younger and more likely to undergo both prophylactic mastectomy and immediate reconstruction. They experienced more postoperative complications and infection compared to SSM patients.
