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Nipple Discharge After Nipple-Sparing Mastectomy With and Without Associated Pregnancy.

Abstract：

BACKGROUND:Nipple-sparing mastectomies (NSMs) preserve the intact nipple, including nipple duct orifices. Retained orifices might remain patent and communicate with the underlying reconstruction. We report the incidence and outcomes of nipple discharge after NSM in pregnant and nonpregnant women. PATIENTS AND METHODS:Retrospective review of all NSMs at our institution from June 2007 to June 2018 was performed. Subsequent pregnancies and nipple discharge were documented. Patient demographic, operative, histopathology, and cancer treatment data were collected. Descriptive analysis was performed for patients who developed nipple discharge. RESULTS:From June 2007 to June 2018, 2778 NSM procedures were performed in 1620 patients, with a mean age of 48 (range, 20-80) years. Fifteen hundred sixty-eight NSMs were therapeutic and 1210 were for risk reduction. Thirty-three subsequent pregnancies were observed in 27 patients, with a mean age of 33 (range, 26-42) years at NSM. Bilateral or unilateral discharge occurred in 6 of 27 (22%) postpartum patients and resolved spontaneously. At 54 months mean follow-up after NSM (range, 16-98 months) and 23 (range, 1-61) months after delivery, no local-regional recurrences were observed. In 1593 patients without subsequent pregnancy, there were 4 patients (0.25%) treated with bilateral NSM with subsequent unilateral watery nipple discharge. There was no evidence of associated malignancy on physical exam, imaging, or cytology, and with 55 to 110 months follow-up, no new or recurrent cancers have been observed. CONCLUSION:Despite extensive removal of nipple and subareolar duct tissue during NSM, milky nipple discharge is possible postpartum. Watery, acellular discharge occurs rarely in nonpregnant patients. To date, no patient with discharge has developed a local recurrence or new breast cancer.

journal_name

Clin Breast Cancer

journal_title

Clinical breast cancer

authors

Tang R,Kelly BN,Smith BL,Lanahan CR,Brown CL,Gadd MA,Hughes KS,Oseni TO,McGugin C,Specht MC,Coopey SB

doi

10.1016/j.clbc.2019.03.003

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

e534-e539

issue

4

eissn

1526-8209

issn

1938-0666

pii

S1526-8209(19)30126-0

journal_volume

19

pub_type

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