Evidence map›Paper›PMID 39402318›Full record

ArticleAnnals of surgical oncology2025

Staged Nipple Delay Procedure Expands Candidacy for Nipple-Sparing Mastectomy.

Xuanji Wang, Jordan Jackson, Christina Weed, Marissa K Boyle, Farin F Amersi, James Mirocha, Armando E Giuliano, Alice P Chung

Abstract read
In one paragraph

Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Xuanji WangCedars-Sinai Medical Center, Los Angeles, CA, USA. xuwang12@gmail.com.
Jordan JacksonCedars-Sinai Medical Center, Los Angeles, CA, USA.
Christina WeedFranciscan Breast Surgery at St. Michael, Silverdale, WA, USA.
Marissa K BoyleCedars-Sinai Medical Center, Los Angeles, CA, USA.
Farin F AmersiCedars-Sinai Medical Center, Los Angeles, CA, USA.
James MirochaCedars-Sinai Medical Center, Los Angeles, CA, USA.
Armando E GiulianoCedars-Sinai Medical Center, Los Angeles, CA, USA.
Alice P ChungCedars-Sinai Medical Center, Los Angeles, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNipple delay (ND) is a staged procedure that improves nipple-areolar complex (NAC) viability in nipple-sparing mastectomy (NSM) patients who are high-risk for NAC or skin-flap necrosis. This study compared postoperative outcomes and risk factors between patients treated with ND-NSM and NSM alone.

methodsPatient demographics, risk factors for NAC or skin-flap necrosis, tumor characteristics, and operative outcomes were compared between ND-NSM and NSM groups from 2009 to 2023. Univariate and multivariate analyses were performed to identify significant variables associated with NAC or skin-flap necrosis.

resultsOverall, 71 ND-NSM patients and 537 NSM patients were compared. ND-NSM patients had larger breasts (p < 0.01), body mass index ≥ 30 (p = 0.01), prior breast/chest wall radiation (XRT) [p < 0.01], prior breast operations (p < 0.01), less axillary surgery (p < 0.01), more autologous tissue reconstruction over implant-based reconstruction compared with NSM patients (p = 0.02), and more prophylaxis (p < 0.01). There were no statistically significant differences between groups in regard to infection, skin-flap necrosis, NAC necrosis, seromas, and hematomas. No patients in the ND-NSM group had NAC necrosis and 1 patient had skin-flap necrosis, compared with 17 and 13 patients in the NSM group, respectively (p = 0.24). On univariate analysis, prior XRT was associated with increased risk for skin-flap necrosis (p = 0.02). Multivariate analysis showed XRT was associated with skin-flap necrosis (p = 0.02) and any necrosis (p = 0.01). Breast size was associated with NAC or skin-flap necrosis (p = 0.04).

conclusionLarger breasts and XRT were risk factors for NAC or skin-flap necrosis; however, despite having more risk factors, ND-NSM patients had very low rates of necrosis. Notably, no nipples were lost. A shared decision should be made with patients regarding the risks and benefits of ND-NSM.

Indexed as

Breast NeoplasmsMammaplastyNipplesAdultAgedFemaleFollow-Up StudiesHumansMastectomyMastectomy, SubcutaneousMiddle AgedNecrosisOrgan Sparing TreatmentsPostoperative ComplicationsPrognosisRetrospective StudiesBreast cancerNipple-areolar complex necrosisNipple delayNipple-sparing mastectomySkin-flap necrosisSurgical outcome

Identifiers

PMID39402318
PMCPMC11659364

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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.