Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Use of Magnetic Resonance Imaging for Evaluating Residual Breast Tissue After Robotic-Assisted Nipple-Sparing Mastectomy in Women With Early Breast Cancer

  • Wen-Pei Wu (Department of Radiology, Changhua Christian Hospital) ;
  • Hung-Wen Lai (Kaohsiung Medical University) ;
  • Chiung-Ying Liao (Department of Radiology, Changhua Christian Hospital) ;
  • Joseph Lin (Division of General Surgery, Changhua Christian Hospital) ;
  • Hsin-I Huang (Department of Information Management, National Sun Yat-sen University) ;
  • Shou-Tung Chen (Division of General Surgery, Changhua Christian Hospital) ;
  • Chen-Te Chou (Department of Radiology, Changhua Christian Hospital) ;
  • Dar-Ren Chen (Division of General Surgery, Changhua Christian Hospital)
  • Received : 2022.09.29
  • Accepted : 2023.05.17
  • Published : 2023.07.01
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Abstract

Objective: Prospective studies on postoperative residual breast tissue (RBT) after robotic-assisted nipple-sparing mastectomy (R-NSM) for breast cancer are limited. RBT presents an unknown risk of local recurrence or the development of new cancer after curative or risk-reducing mastectomies. This study investigated the technical feasibility of using magnetic resonance imaging (MRI) to evaluate RBT after R-NSM in women with breast cancer. Materials and Methods: In this prospective pilot study, 105 patients, who underwent R-NSM for breast cancer at Changhua Christian Hospital between March 2017 and May 2022, were subjected to postoperative breast MRI to evaluate the presence and location of RBT. The postoperative MRI scans of 43 patients (age, 47.8 ± 8.5 years), with existing preoperative MRI scans, were evaluated for the presence and location of RBT. In total, 54 R-NSM procedures were performed. In parallel, we reviewed the literature on RBT after nipple-sparing mastectomy, considering its prevalence. Results: RBT was detected in 7 (13.0%) of the 54 mastectomies (6 of the 48 therapeutic mastectomies and 1 of the 6 prophylactic mastectomies). The most common location for RBT was behind the nipple-areolar complex (5 of 7 [71.4%]). Another RBT was found in the upper inner quadrant (2 of 7 [28.6%]). Among the six patients who underwent RBT after therapeutic mastectomies, one patient developed a local recurrence of the skin flap. The other five patients with RBT after therapeutic mastectomies remained disease-free. Conclusion: R-NSM, a surgical innovation, does not seem to increase the prevalence of RBT, and breast MRI showed feasibility as a noninvasive imaging tool for evaluating the presence and location of RBT.

Keywords

Acknowledgement

The authors would like to thank Chin-Mei Tai, Yi-Ru Ke, Shu-Hsin Pai, and Ya Ting Zhung for the assistance in this study.

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