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| Breast cancer research and treatment. 2018 Sep 4. doi: 10.1007/s10549-018-4937-1. pii: 10.1007/s10549-018-4937-1 |
| Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy. |
| Weber WP1, Haug M2, Kurzeder C3, Bjelic-Radisic V4, Koller R5, Reitsamer R6, Fitzal F7, Biazus J8, Brenelli F9, Urban C10, Paulinelli RR11, Blohmer JU12, Heil J13, Hoffmann J14, Matrai Z15, Catanuto G16, Galimberti V17, Gentilini O18, Barry M19, Hadar T20, Allweis TM21, Olsha O22, Cardoso MJ23, Gouveia PF24, Rubio IT25, de Boniface J26, Svensjö T27, Bucher S28, Dubsky P29, Farhadi J30, Fehr MK31, Fulco I32, Ganz-Blättler U33, Günthert A34, Harder Y35, Hauser N36, Kappos EA37, Knauer M38, Landin J39, Mechera R40, Meani F41, Montagna G42, Ritter M43, Saccilotto R44, Schwab FD45, Steffens D46, Tausch C47, Zeindler J48, Soysal SD49, Lohsiriwat V50, Kovacs T51, Tansley A52, Wyld L53, Romics L54, El-Tamer M55, Pusic AL56, Sacchini V57, Gnant M58 |
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Abstract PURPOSE: Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion. METHODS: The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology. RESULTS: Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference. CONCLUSIONS: In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques. |
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KEYWORDS: Breast cancer surgery, Immediate breast reconstruction, Nipple-sparing mastectomy |
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Publikations ID: 30182349 Quelle: öffnen |
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