Outcomes and feasibility of nipple-sparing mastectomy for node-positive breast cancer patients

Brittany L. Murphy, Tanya L. Hoskin, Judy C Boughey, Amy C Degnim, James W Jakub, Adam C. Krajewski, Steven R. Jacobson, Tina J Hieken

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background: While nipple-sparing mastectomy (NSM) is gaining acceptance for risk reduction and for treatment of early stage breast cancer, node-positive disease remains a relative contraindication. Our aim was to evaluate the use and outcomes of NSM in node-positive breast cancer patients. Methods: We identified 240 cancers in 226 patients (14 bilateral) scheduled for NSM and operated on between 1/2009 and 6/2014. We compared outcomes for 58 node-positive vs 182 node-negative patients. Results: Intraoperative conversion to skin-sparing mastectomy was similar for node-positive and node-negative patients, 10% and 7%, as was 1-year success of NSM, 84% and 90%, respectively. Five-year locoregional disease-free estimates were 82% (95% CI 68%-99%) for node-positive and 99% (95% CI 96%-100%) for node-negative patients, . P = .004; however, there were no nipple-areolar recurrences among node-positive patients. Conclusions: With careful consideration of biologic and anatomic risk factors for recurrence, these data suggest that NSM is a reasonable option for selected node-positive breast cancer patients.

Original languageEnglish (US)
JournalAmerican Journal of Surgery
StateAccepted/In press - 2016


  • Breast cancer
  • Local recurrence
  • Lymph node
  • Nipple-sparing mastectomy
  • Node-positive
  • Outcomes

ASJC Scopus subject areas

  • Surgery


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