Large Nipple Volume as a Risk Factor of Nipple?areola Complex Necrosis Following Nipple-sparing Mastectomy
Large Nipple Volume as a Risk Factor of Nipple?areola Complex Necrosis Following Nipple-sparing Mastectomy
复制标题
乳头体积大是保留乳头乳房切除术后乳头乳晕复合体坏死的危险因素
DOI：
10.1007/s00268-022-06458-4
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发表时间：
2022
影响因子：
2.6
通讯作者：
Sasajima Yuko
中科院分区：
文献类型：
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作者：
Yamada Miki;Jinno Hiromitsu;Naruse Saki;Isono Yuka;Tsukahara Daisuke;Umemoto Yasuko;Matsumoto Akiko;Dogo Kyoko;Sasajima Yuko
研究背景乳头乳晕复合体（NAC）坏死是保留乳头乳腺切除术的并发症之一，是局部缺血引起的。肥胖、吸烟、糖尿病和立即乳房再造已被确定为NAC坏死的危险因素。本研究探讨了NAC坏死与乳头体积之间的相关性。材料与方法回顾性分析了2016年1月至2019年12月期间接受NSM治疗的83例原发性乳腺癌患者。乳头体积采用公式确定：体积（mm 3）=长×宽×高（mm），测量值采用对比增强磁共振成像确定。全部和部分NAC坏死被定义为全层坏死，需要外科手术和表皮坏死管理本地伤口careers.ResultsNAC坏死观察到30例（36%），3和27例患者有全部和部分坏死，分别。大乳头体积（56%对24%，p = 0.006）、吸烟和立即乳房再造（分别为57%对28%，p = 0.017; 48%对20%，p = 0.009）与NAC坏死显著相关。多变量分析确定乳头体积是NAC坏死的独立危险因素（OR，3.75; 95%CI，1.23-11.44;p= 0.02）。吸烟（OR，4.68; 95%CI，1.37-15.94;p= 0.014）和立即乳房再造（OR，3.43; 95%CI，1.05-11.23;p= 0.042）也独立与NAC necross.ConclusionsThis研究表明，大乳头体积可能是NSM后NAC坏死的危险因素之一。
BackgroundNipple–areola complex (NAC) necrosis, which is caused by local ischemia, remains one of the complications associated with nipple-sparing mastectomy. Obesity, smoking, diabetes mellitus, and immediate breast reconstruction have been identified as risk factors of NAC necrosis. The current study examined the correlation between NAC necrosis and nipple volume.Materials and methodsA total of 83 patients who underwent NSM for primary breast cancer from January 2016 to December 2019 were retrospectively analyzed. Nipple volume was determined using the formula: volume (mm3) = length × width × height (mm), with measurements determined using contrast-enhanced magnetic resonance imaging. Total and partial NAC necrosis was defined as full-thickness necrosis requiring surgical procedures and epidermal necrosis managing local wound care, respectively.ResultsNAC necrosis was observed in 30 patients (36%), with 3 and 27 patients having total and partial necrosis, respectively. Large nipple volume (56% vs. 24%,p= 0.006), as well as smoking and immediate breast reconstruction (57 vs. 28%,p= 0.017; 48% vs. 20%, p = 0.009, respectively), were significantly correlated with NAC necrosis. Multivariate analysis identified nipple volume as an independent risk factor for NAC necrosis (OR, 3.75; 95% CI, 1.23–11.44;p= 0.02). Smoking (OR, 4.68; 95% CI, 1.37–15.94;p= 0.014) and immediate breast reconstruction (OR, 3.43; 95% CI, 1.05–11.23;p= 0.042) were also independently associated with NAC necrosis.ConclusionsThis study suggested that a large nipple volume could be one of the risk factors for NAC necrosis following NSM.