Background and objective: Modified radical mastectomy of preserving nipple-areolar complex (NAC) is an important surgical therapy for stage I-IIa breast cancer, but the oncological risk is controversial. This study was to compare the efficacy of NAC-preserving modified radical operation and conventional modified radical operation on early stage breast cancer.
Methods: The patients who received NAC-preserving modified radical operation (42 patients) or conventional modified radical operation (84 patients) from January 1998 to December 2003 in the First Affiliated Hospital of Bengbu Medical College were matched with a ratio of 1:2 by age at diagnosis, axillary lymph node status, sexual hormone receptor status, tumor size and Her-2/neu expression for retrospective analysis. The loco-regional recurrence, distant metastasis, 5-year disease-free survival (DFS) and 5-year overall survival (OS) between the two groups were compared.
Results: Median follow-up time was 48 months in NAC-preserving operation group and 44 months in conventional operation group. The 5-year occurrence rate of loco-regional recurrence was 2.44% in NAC-preserving operation group and 3.21% in conventional operation group (P=0.771). The 5-year occurrence rate of distant metastasis was 5.64% in NAC-preserving operation group and 4.30% in conventional operation group (P=0.654). The 5-year OS rates were 96.00% in NAC-preserving operation group and 98.18% in conventional operation group (P=0.694). The 5-year DFS rates were 91.67% in NAC-preserving operation group and 92.26% in conventional operation group (P=0.597).
Conclusion: Modified NAC-preserving radical operation results in the same effect on early stage breast cancer as conventional modified radical operation based on careful consideration of the indications, and results in better cosmetic appearance after restitution and better quality of life.