ArticleFrontiers in oncology2026
Evaluating the impacts of previous breast surgery on surgical complications and aesthetic outcomes in reverse-sequence endoscopic-assisted nipple-sparing mastectomy with or without direct-to-implant breast reconstruction.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: The reverse-sequence endoscopic-assisted nipple-sparing mastectomy (R-E-NSM), with or without direct-to-implant breast reconstruction (DTI-BR), has become increasingly popular in China. This study aimed to evaluate whether previous breast surgery (PBS) affects surgical complications and aesthetic outcomes after R-E-NSM. Methods: Clinical data of patients who underwent R-E-NSM at the Breast Center, West China Hospital, Sichuan University, between April 30, 2020, and April 30, 2025, were prospectively collected and analyzed. Results: A total of 1081 patients were enrolled in the study. Among them, 89 had intraoperative breast surgery (IBS), 56 had short-term previous breast surgery (SPBS), 75 had long-term previous breast surgery (LPBS), and 861 had no previous breast surgery (NPBS). SPBS and IBS were not significantly associated with increased complication risk after multivariable adjustment (all P > 0.05). LPBS was significantly associated with lower odds of any complications (OR, 0.238; 95% CI, 0.089-0.633; P = 0.040), minor complications (OR, 0.304; 95% CI, 0.122-0.752; P = 0.010), and CDC ≥ 2 complications (OR, 0.333; 95% CI, 0.125-0.885; P = 0.027). BREAST-Q scores did not differ significantly among groups. Compared with the NPBS group, the SPBS group showed a statistically significant difference in Ueda scores at 3 months (P = 0.014). Oncologic outcomes did not differ significantly among the four groups (all P > 0.05). Conclusion: For patients with SPBS, implementing R-E-NSM warrants careful clinical evaluation due to potential safety concerns. Among patients with LPBS, current evidence indicates that incorporating R-E-NSM is not an independent risk factor and may be linked to a significantly lower incidence of complications.
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