Free nipple-areolar complex grafting combined with reconstruction for unavoidable mastectomy

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OBJECTIVE

To determine advisability of free nipple-areolar complex grafting in patients with breast cancer at various stages of disease; to establish the effect of various breast implants, neoadjuvant chemotherapy and adjuvant radiotherapy on nipple-areolar complex grafting.

MATERIAL AND METHODS

There were 16 free nipple-areolar complex grafting procedures at the St. Petersburg Clinical Hospital of the Russian Academy of Sciences in patients with stage I-IIIB breast cancer between June 2021 and July 2023. All patients underwent total mastectomy with various mammoplasty options.

RESULTS

Fourteen (87.5%) patients had favorable results with complete engraftment of the nipple-areolar complex, 1 (6.3%) patient developed central nipple necrosis, another (6.3%) patient had hypopigmentation and complete involution of the nipple-areolar complex. Thirteen (81.2%) patients underwent neoadjuvant chemotherapy before total mastectomy. Radiotherapy was performed in 4 (25%) patients within 4-6 weeks after surgery. Two (12.6%) patients underwent tissue expander replacement with permanent implants in 14 months and 6 months after the first stage of reconstruction with nipple-areolar complex grafting.

CONCLUSION

Cancer stage, neoadjuvant chemotherapy and type of implant do not affect survival of the nipple-areolar complex. The transplanted autologous tissues satisfactorily tolerate expansion to create necessary volume for the second stage of reconstruction. Modern radiotherapy is not a limitation for free nipple-areolar complex grafting.

Keywords:

breast cancer

mastectomy

nipple-areolar complex

reconstruction

free transplantation

Authors:

Skurikhin S.S.

St. Petersburg Clinical Hospital of the Russian Academy of Sciences

ORCID: 0000-0002-8896-1759

Sitnikov A.E.

St. Petersburg Clinical Hospital of the Russian Academy of Sciences

Chagunava O.L.

St. Petersburg Clinical Hospital of the Russian Academy of Sciences

Received:

15.01.2024

Accepted:

15.05.2024

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