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Skin and nipple sparing surgery: still a matter of debate

BCC 2019

A vast majority of the panel (83%) agreed that in patients with inflammatory breast cancer, the risk of local recurrence when preserving the skin envelop (i.e. skin sparing mastectomy) outweighs the gains in cosmetics even with a clinical complete response to neoadjuvant systemic therapy and therefore should not be performed in these patients, whatever the extent of disease at the time of surgery. When asked for their opinion on the risks vs gains of preserving the skin envelope in patients without clinical signs of skin infiltrations, but tumours radiologically “reaching” the skin in preoperative imaging, the panellists did not reach any consensus: 38% of the panellists voted “yes”, 40% voted “no”. Can skin and nipple be preserved in cases were imaging suggests a centrally located tumour near the nipple? No consensus could be reached here, either: 38% of the panellists were of the opinion that skin and nipple sparing surgery should be avoided, 43% of the panellists were in favour of skin and nipple sparing surgery in these cases.

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