Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy

Publication

Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy

Journal Paper/Review - Sep 4, 2018

Gnant Michael, Montagna Giacomo, Meani Francesco, Mechera Robert, Landin Julia, Knauer Michael, Kappos Elisabeth A, Hauser Nik, Harder Yves, Günthert Andreas, Ganz-Blättler Ursula, Fulco Ilario, Fehr Mathias K, Ritter Mathilde, Saccilotto Ramon, Schwab Fabienne D, Sacchini Virgilio, Pusic Andrea L, El-Tamer Mahmoud, Romics Laszlo, Wyld Lynda, Tansley Anne, Kovacs Tibor, Lohsiriwat Visnu, Soysal Savas D, Zeindler Jasmin, Tausch Christoph, Steffens Daniel, Farhadi Jian, Dubsky Peter, Heil Jörg, Blohmer Jens-Uwe, Paulinelli Régis Resende, Urban Cicero, Brenelli Fabricio, Biazus Jorge, Fitzal Florian, Reitsamer Roland, Koller Rupert, Bjelic-Radisic Vesna, Kurzeder Christian, Haug Martin, Hoffmann Jürgen, Matrai Zoltan, Catanuto Giuseppe, Bucher Susanne, Svensjö Tor, de Boniface Jana, Rubio Isabel T, Gouveia Pedro F, Cardoso Maria João, Olsha Oded, Allweis Tanir M, Hadar Tal, Barry Mitchel, Gentilini Oreste, Galimberti Viviana, Weber Walter P

Citation

Gnant M, Montagna G, Meani F, Mechera R, Landin J, Knauer M, Kappos E, Hauser N, Harder Y, Günthert A, Ganz-Blättler U, Fulco I, Fehr M, Ritter M, Saccilotto R, Schwab F, Sacchini V, Pusic A, El-Tamer M, Romics L, Wyld L, Tansley A, Kovacs T, Lohsiriwat V, Soysal S, Zeindler J, Tausch C, Steffens D, Farhadi J, Dubsky P, Heil J, Blohmer J, Paulinelli R, Urban C, Brenelli F, Biazus J, Fitzal F, Reitsamer R, Koller R, Bjelic-Radisic V, Kurzeder C, Haug M, Hoffmann J, Matrai Z, Catanuto G, Bucher S, Svensjö T, de Boniface J, Rubio I, Gouveia P, Cardoso M, Olsha O, Allweis T, Hadar T, Barry M, Gentilini O, Galimberti V, Weber W. Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy. Breast Cancer Res Treat 2018

Type

Journal Paper/Review (English)

Journal

Breast Cancer Res Treat 2018

Publication Date

Sep 4, 2018

Issn Electronic

1573-7217

Brief description/objective

PURPOSE
Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion.

METHODS
The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology.

RESULTS
Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference.

CONCLUSIONS
In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques.