Evidence map›Paper›PMID 39751979›Full record

ArticleAnnals of surgical oncology2025

The Age-Old Question in Nipple-Sparing Mastectomy: Is Older Age a Contraindication?

Francys C Verdial, Kyle J Anderman, Abigail E Daly, Tolga Ozmen, Rebecca Kwait, Tawakalitu S Oseni, Amy S Colwell, Michelle C Specht, Michele A Gadd, Barbara L Smith

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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 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

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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

1 citing paper in PubMed.

  1. Review
4 · The record

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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

10 authors.

Francys C VerdialBreast Surgery Section, Division of GI and Oncologic Surgery, Massachusetts General Hospital, Boston, MA, USA. fverdial@mgh.harvard.edu.
Kyle J AndermanBreast Surgery Section, Division of GI and Oncologic Surgery, Massachusetts General Hospital, Boston, MA, USA.
Abigail E DalyBreast Surgery Section, Division of GI and Oncologic Surgery, Massachusetts General Hospital, Boston, MA, USA.
Tolga OzmenBreast Surgery Section, Division of GI and Oncologic Surgery, Massachusetts General Hospital, Boston, MA, USA.
Rebecca KwaitBreast Surgery Section, Division of GI and Oncologic Surgery, Massachusetts General Hospital, Boston, MA, USA.
Tawakalitu S OseniBreast Surgery Section, Division of GI and Oncologic Surgery, Massachusetts General Hospital, Boston, MA, USA.
Amy S ColwellDivision of Plastic Surgery, Massachusetts General Hospital, Boston, MA, USA.
Michelle C SpechtBreast Surgery Section, Division of GI and Oncologic Surgery, Massachusetts General Hospital, Boston, MA, USA.
Michele A GaddBreast Surgery Section, Division of GI and Oncologic Surgery, Massachusetts General Hospital, Boston, MA, USA.
Barbara L SmithBreast Surgery Section, Division of GI and Oncologic Surgery, Massachusetts General Hospital, Boston, MA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNipple-sparing mastectomy (NSM) is infrequently performed in older women, at least in part owing to concerns regarding age-related complications. We describe postoperative outcomes of NSM in older women and risk factors for complications, with the goal of informing patient selection and decision-making. PATIENTS AND

methodsCases of NSM with immediate implant-based reconstruction were identified from an institutional database (2009-2019). Patient characteristics and postoperative complications were compared between women 45-54 years, 55-64 years, and  ≥ 65 years. Regression models were used to identify risk factors for serious complications and reconstruction failure.

resultsOf 1998 NSMs in 1197 women, 1296 were in women 45-54 years, 521 in women 55-64 years, and 181 in women ≥ 65 years. Women ≥ 65 years had higher rates of comorbidities and more frequently incurred early postoperative complications (11% versus 7.3% in 55-64 years and 5.2% in 45-54 years, p = 0.005), particularly hematoma (5.0% versus 1.5% in 55-64 years and 1.2% in 45-54 years, p < 0.001). On univariate analysis, unadjusted rates of infection, necrosis, serious complications, and reconstruction failure did not differ significantly by age. Permanent reconstruction failure occurred in eight (4.4%) women ≥ 65 years. On multivariable analysis, age was not an independent predictor of serious complications or reconstruction failure, though current smoking, in addition to factors more common in older women (diabetes, hypertension, anticoagulation, prior radiotherapy), emerged as independent risk factors.

conclusionsAfter adjusting for patient factors, older age did not increase risk of complications after NSM. Studies on functional and quality-of-life outcomes may help further refine patient selection and facilitate decision-making.

Indexed as

Breast NeoplasmsMammaplastyNipplesOrgan Sparing TreatmentsPostoperative ComplicationsAgedAge FactorsContraindications, ProcedureFemaleFollow-Up StudiesHumansMiddle AgedPrognosisRetrospective StudiesRisk FactorsBreast cancerBreast reconstructionElderlyNipple-sparing mastectomySurgical complications

Identifiers

PMID39751979

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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.