Evidence map›Paper›PMID 34291379›Full record

ArticleAnnals of surgical oncology2021

Two-Stage Versus One-Stage Nipple-Sparing Mastectomy: Timing of Surgery Prevents Nipple Loss.

Tammy Ju, Julia Chandler, Arash Momeni, Geoffrey Gurtner, Jacqueline Tsai, Dung Nguyen, Irene Wapnir

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Article in Annals of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Tammy JuSection of Surgical Oncology, Department of Surgery, Stanford University School of Medicine Stanford, Stanford, CA, USA.
Julia ChandlerSection of Surgical Oncology, Department of Surgery, Stanford University School of Medicine Stanford, Stanford, CA, USA.
Arash MomeniDivision of Plastic Surgery, Department of Surgery, Stanford University School of Medicine Stanford, Stanford, CA, USA.
Geoffrey GurtnerDivision of Plastic Surgery, Department of Surgery, Stanford University School of Medicine Stanford, Stanford, CA, USA.
Jacqueline TsaiSection of Surgical Oncology, Department of Surgery, Stanford University School of Medicine Stanford, Stanford, CA, USA.
Dung NguyenDivision of Plastic Surgery, Department of Surgery, Stanford University School of Medicine Stanford, Stanford, CA, USA.
Irene WapnirSection of Surgical Oncology, Department of Surgery, Stanford University School of Medicine Stanford, Stanford, CA, USA. wapnir@stanford.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDevascularization of the nipple-areola complex (NAC) before nipple-sparing mastectomy (NSM) enhances blood flow to the skin. This study analyzed the effect of the interval between stages in two-stage (2S) operations and compared the ischemic events with those of one-stage (1S) NSM.

methodsIschemic complications were defined as partial/reversible (PR) or full-thickness/irreversible (FI) skin necrosis of the NAC or flap. The latter encompassed limited areas of the NAC, resulting in loss of nipple height or areolar circumference without affecting the integrity or appearance of the NAC. Outcomes between the two groups were compared using chi-square and both uni- and multivariate analyses.

resultsFrom 2015 to 2019, 109 breasts underwent 2S NSM and 103 breasts underwent 1S NSM. Grade 2 or 3 breast ptosis was more common in the 2S group than in the 1S group (60.5% vs 30.5%; p < 0.01). The median time between devascularization and NSM was 30 days (range, 11-415 days). After devascularization, ischemic events occurred in 25.7% of the breasts. Nipple loss occurred in 7.8% of the 1S group and 0% of the 2S group. Both PR and FI NAC ischemic events were observed in 66.7% of the breasts when NSM took place fewer than 20 days (n = 9) after devascularization versus 15% when NSM took place 20 days or longer afterward (n = 100). Overall, NAC, flap ischemic complications, or both occurred in 35.9% of the 1S group versus 20.2% of the 2S group (p < 0.05). In the multivariate analysis, the odds ratio of ischemic complications in the 2S versus the 1S group was 0.38 (range, 0.19-0.75).

conclusionsFewer ischemic complications and no nipple loss occurred in 2S NSM. Ischemic events are fewer when the interval between devascularization and NSM is 20 days or longer.

Indexed as

Breast NeoplasmsMammaplastyMastectomy, SubcutaneousFemaleHumansMastectomyNipplesRetrospective Studies

Identifiers

PMID34291379

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.