Pregnancy Associated Breast Changes after Nipple Sparing Mastectomy".
Academic Article
Overview
abstract
BACKGROUND: Women of reproductive age are chronically underrepresented in breast cancer studies. Recent studies suggest that almost 40% of patients diagnosed with breast cancer, who are of reproductive age, want to have children after completing treatment. In this study, we evaluate patients of reproductive age who have undergone nipple sparing mastectomy (NSM) and implant-based reconstruction. We compare those who have become pregnant and those who have not, with respect to clinical and radiologic changes that are reported on follow-up. METHODS: Any patient 45 years of age or younger at the time of NSM was defined to be of reproductive age and selected for evaluation and followed prospectively. The presence or absence of breast exam changes in the setting of pregnancy after NSM were recorded. RESULTS: 35 patients became pregnant after NSM and 159 patients did not become pregnant after NSM. Of those who became pregnant, nearly half reported some clinical change just prior to, or immediately after delivery. These included color change and discharge at the residual nipple areolar complex, and palpable nodularity elsewhere. For those with palpable changes, an ultrasound was performed and hypoechoic lesions with variable vascularity were identified. For those who went on to excision, lactational hyperplasia was the most common diagnosis. CONCLUSIONS: Ultrasound is an appropriate first line investigation of changes which can include hyperplasia of remaining ductal and glandular tissue. Patients who became pregnant after NSM commonly had clinical breast exam changes, however the majority of these changes are found to be benign on further evaluation.
