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Lisa K. Jacobs, MD; Anna M. Voltura, MD

Arch Surg. 2008;143(11):1110.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

When considering NSM, the most important factor is the oncologic safety of the procedure. There are populations of patients, specifically those undergoing prophylactic mastectomy, where NSM is a good choice. However, in patients with breast cancer, the oncologic safety becomes paramount. The Crowe et al article is a triumph in number of cases and developed technique, but it provides less convincing evidence that NSM is oncologically sound.

To know if this is a safe cancer operation, we must determine if the risk of local recurrence is increased by leaving the NAC. Of the 43 patients with invasive breast cancer reported, 4 developed recurrence, a 9% recurrence rate. The recurrence rate after mastectomy is 3% to 6%, and for lumpectomy and radiation therapy, it is 6% to 8%. One must question whether NSM results in equivalent local control compared with standard therapies. While . . . [Full Text of this Article]

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