乳头保留乳房切除术（NSM）已广泛用于乳腺癌预防。其长期肿瘤安全性的数据有限。该研究的目的是确定接受预防性乳头保留乳房切除术的患者中乳腺癌的发生率。回顾性地审查了2006年至2019年单个机构进行的预防性NSM的所有患者。记录了患者人口统计学因素、遗传易感性、乳房切除标本病理学以及随访时的肿瘤事件。在必要时执行描述性统计，以分类人口统计学因素和肿瘤特征。641名患者进行了871例预防性NSM，随访中位数为82.0个月（标准误差1.24）。94.4％（n = 605）的患者接受了双侧NSM，但仅考虑预防性乳房切除术。大多数乳房切除标本（69.6％）未发现可识别的病理学。有38个标本（4.4％）在乳房切除标本中发现了癌症，其中管状癌原位癌是最常见的（92.1％，n = 35）。多灶性或多中心性疾病观察到7例（18.4％），淋巴血管浸润症状被识别出2例（5.3％）。1名患者（0.16％）在预防性乳房切除术后6.5年被发现患有乳腺癌。该患者为BRCA2携带者。高风险患者接受预防性NSM的总体原发性肿瘤发生率非常低。除降低肿瘤发生风险外，预防性手术本身可能在小部分患者中具有治疗作用。继续对这些患者进行监测以评估更长的随访间隔至关重要。版权所有©2023年由美国整形外科医师协会。

Nipple sparing mastectomies (NSM) have become widely available for breast cancer prophylaxis. There is limited data on its long-term oncologic safety. The objective of this study was to determine the incidence of breast cancer in patients who underwent prophylactic NSM.All patients undergoing prophylactic NSM at a single institution from 2006-2019 were retrospectively reviewed. Patient demographic factors, genetic predispositions, mastectomy specimen pathology, and oncologic occurrences at follow-up were recorded. Descriptive statistics were performed where necessary to classify demographic factors and oncologic characteristics.871 prophylactic NSMs were performed on 641 patients, with median follow-up of 82.0 months (standard error 1.24). 94.4% (n=605) of patients underwent bilateral NSMs, though only the prophylactic mastectomy was considered. The majority of mastectomy specimens (69.6%) had no identifiable pathology. 38 specimens (4.4%) had cancer identified in mastectomy specimens, with ductal carcinoma in situ being the most common (92.1%, n=35). Multifocal or multicentric disease was observed in 7 (18.4%) cases and lympho-vascular invasion was identified in 2 (5.3%). 1 patient (0.16%) was found to have breast cancer 6.5 years after prophylactic mastectomy. This patient was a BRCA2 carrier.Overall primary oncologic occurrence rates are very low in high-risk patients undergoing prophylactic NSM. In addition to reducing the risk of oncologic occurrence, prophylactic surgery itself may be therapeutic in a small proportion of patients. Continued surveillance for these patients remains important to assess at longer follow-up intervals.Copyright © 2023 by the American Society of Plastic Surgeons.