Therapeutic nipple-sparing mastectomy: trends based on a national cancer database

BACKGROUND: Current reports on nipple-sparing mastectomy (NSM) are limited to single-institution series. We use the National Cancer Institute's Surveillance, Epidemiology, and End Results database to report on the national experience with NSM. METHODS: Population-level deidentified data were extracted from the Surveillance, Epidemiology, and End Results database. All female breast cancer patients treated with NSM from 2005 to 2009 were included. Case analysis was performed with respect to demographic and oncologic characteristics. RESULTS: Four hundred forty-nine patients underwent therapeutic NSM; this number increased from 66 patients in 2005 to 133 in 2009. Patients were distributed across 16 regions, although nearly 50% were from a region of California. Tumor diameter was <2 cm in 224 patients (50%). Lymph nodes were positive in 59 patients (13%), while radiation was delivered to 74 patients (16%). CONCLUSIONS: NSM use has been increasing over the past several years. A majority of patients have tumor size <2 cm, although the number of patients with tumor size >= 2 cm has increased over time. Further population-based studies of NSM may benefit from collection of oncologic data such as tumor-to-nipple distance and tumor location. (C) 2014 Elsevier Inc. All rights reserved.