Recurrence at Nipple Areola Complex and Safety of Nipple-Sparing Mastectomy —Reply

In Reply We thank Han and Lee for their insightful comments regarding our article. As Han and Lee suggest, we agree that the analysis of distant metastasis (DM) –free survival might include selection bias because the patients with cancer recurrence at the nipple-areola complex (NAC) as the first event had already survived for a long duration without DM before being assigned to the recurrence group. Nevertheless, in our study, of the 39 patients who experi enced recurrence at the NAC as the first event, 2 developed subsequent DM (5.1%). Meanwhile, of the 923 patients who did not experience recurrence at the NAC as the first event, 48 developed DM (5.2%). The DM rates of these 2 groups were almost equal. Furthermore, all patients with cancer recurrence at the NAC as the first event survived with a mean follow-up duration of 51 months (range, 5-121 months) after NAC removal. It seems reasonable to conclude that patients with cancer recurrence at the NAC can have an excellent prognosis after appropriate treatment.
Source: JAMA Surgery - Category: Sports Medicine Source Type: research