Gland surgery
July 17, 2026 · via Europe PMC
Local recurrence in nipple-sparing mastectomy without intraoperative radiotherapy (IORT) in breast cancer.
Chirappapha P, Watanakun W, Lapkittichot S, +6 more, Adireklarpwong L.
AI summary — for doctors, generated from the abstract only
Nipple-sparing mastectomy with immediate reconstruction without intraoperative radiotherapy achieved a 6% locoregional recurrence rate at a median 72 months, with selective whole-breast radiotherapy not significantly affecting recurrence or survival.
What was studied
Retrospective review of 148 NSMs for DCIS or invasive breast cancer with immediate reconstruction without IORT (2007-2021), with whole breast RT given selectively to 28%.
Key findings
- Mean age 43; 80% premenopausal; 94% T1-T2; 64% node-negative; 82% ER-positive
- Positive margins in 7%
- Locoregional recurrence 6% (9 patients) at median 72 months
- 10-year OS 100% without RT vs 94.7% with RT (P=0.08); DFS 88.2% vs 97.6% (P=0.24)
Clinical relevance
This suggests NSM without IORT, with RT selected by tumor, nodal, and margin status, can achieve low recurrence, though the small retrospective cohort cannot define who benefits from RT.
Who should care
Limitations
Small retrospective single-center cohort with selection bias in RT use and limited power for recurrence and survival comparisons.
Nipple-sparing mastectomy without intraoperative radiation had low local recurrence in this series.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Nipple-sparing mastectomy (NSM) is increasingly used in breast cancer treatment. Concerns remain about residual tissue beneath the nipple-areolar complex (NAC) and the risk of locoregional recurrence (LRR). This study aimed to evaluate recurrence in NSM patients with or without radiation therapy (RT) and to assess the role of RT.
Methods
Retrospective review of patients with ductal carcinoma in situ (DCIS) or invasive breast cancer who underwent NSM with immediate reconstruction without intraoperative radiotherapy (IORT) from January 2007 to July 2021. LRR was the primary outcome; secondary outcomes included overall survival (OS), disease-free survival (DFS), and factors associated with outcomes and RT use.
Results
A total of 148 NSMs were analyzed, including 116 invasive cancers and 33 DCIS cases. The mean age was 43 years, most patients were premenopausal (80%), T1 to T2 (94%), node-negative (64%), and estrogen receptor (ER) positive (82%). Positive margins occurred in 10 patients (7%). Chemotherapy was administered to 91 (68%), hormonal therapy to 118 (83%), and trastuzumab to half of 21 human epidermal growth factor receptor 2 (HER2) positive patients. Whole breast RT was given to 42 patients (28%). After a median follow-up of 72 months, 9 patients (6%) experienced LRR. RT did not significantly affect recurrence or survival. Ten-year OS was 100% vs. 94.7% (P=0.08) and DFS was 88.2% vs. 97.6% (P=0.24) for patients without and with RT, respectively.
Conclusions
NSM without IORT is safe, and selective RT guided by tumor, nodal, and margin status achieves low LRR, even in higher-risk patients.
DOI
10.21037/gs-2026-0272
PMID
42724951
PMCID
PMC13561613
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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