28572 – POSTOPERATIVE COMPLICATIONS FOLLOWING NIPPLE-SPARING MASTECTOMY: COMPARISON OF NEOADJUVANT AND ADJUVANT CHEMOTHERAPY

Abstract

Introduction: Nipple-sparing mastectomy (NSM) is a conservative mastectomy approach for breast cancer and prophylactic management in high-risk patients, ensuring oncological safety and good aesthetic satisfaction. The demand
for NSM has grown in recent years due to expanded patients’ eligibility criteria, including those undergoing neoadjuvant
chemotherapy (NACT). However, concerns persist among surgeons, particularly about postoperative complications, especially nipple-areolar complex (NAC) necrosis. The indication of NSM after NACT is more recent, and literature regarding
complications is still lacking. Methodology: Between January 2004 and December 2022, patients undergoing NSM after
NACT (148 patients) and without neoadjuvant systemic treatment (120 patients referred to adjuvant chemotherapy) were
included. The 30-day postoperative complications were analyzed. The medical chart retrospectively evaluated the data,
and the patients’ follow-ups were updated during the appointments. A senior surgeon operated on all patients, and the
risks and benefits of the NSM were previously discussed with the patients, including the risk of complications and the
concern regarding nipple preservation. Conclusion: Our findings demonstrated similar rates of postoperative complications in patients undergoing NACT and those referred to adjuvant chemotherapy without neoadjuvant systemic treatment.
The study supports the idea that NSM can be considered a safe and effective procedure after NACT in selected patients.