Frey JD, et al. - Authors sought to assess the impact of mastectomy flap thickness regarding complications in nipple-sparing mastectomy (NSM). They observed a significant association of ischemic complications after NSM with thinner postoperative NSM flap thickness. Particularly, NSM flap thickness less than 8.0 mm seemed a positive independent predictor of ischemic complications. In reconstructions with ischemic complications, the ratio of postoperative to preoperative NSM flap thickness was significantly lower.

Methods

• Authors determined NSM flap thickness for all NSMs from 2006 to 2016 with available pre- or postoperative breast magnetic resonance imaging (MRIs).
• They stratified demographics and outcomes by those with and without ischemic complications.

Results

• 1,037 NSM reconstructions were identified; 420 NSMs had MRI data available, these included 379 preoperative MRIs and 60 postoperative MRIs.
• Data suggested that average total preoperative skin/subcutaneous tissue NSM flap thickness was 11.4 mm and average total postoperative NSM flap thickness was 8.7 mm.
• Findings revealed that NSMs with ischemic complications had significantly thinner overall postoperative NSM flap thickness compared with those without ischemic complications (P = 0.0280).
• Authors identified average overall postoperative NSM flap thickness less than 8.0 mm as an independent predictor of ischemic complications (odds ratio, 6.5263; P = 0.026).
• NSMs with both pre- and postoperative MRIs indicated that the overall average postoperative NSM flap thickness was 68.2% of preoperative measurements.
• In this study, average overall postoperative NSM flap thickness was markedly less than average overall preoperative NSM flap thickness (P < 0.0001).
• NSMs with ischemic complications were seemed having a significantly lower ratio of overall postoperative to preoperative flap thickness (52.0% versus 74.0%; P < 0.0001).