Table 5 Literature review of nipple-areolar complex ischemia necrosis rate and risk factors
Reference | Journal | Publish year | Number | Ischemia(%) | Total necrosis | Risk factor of NAC necrosis |
|---|---|---|---|---|---|---|
Komorowski et al. [28] | World J Surg | 2006 | 38 | 5 (13.2%) | 3 (7.9%) | Old age (> 45) |
Garwood et al. [29] | Ann Surg | 2009 | 64 | 19 (30%) | N/a | Autologous reconstruction, incision type |
106 | 14 (13%) | N/a | ||||
Spear et al. [33] | Plast Reconstr Surg | 2011 | 43 | N/A | 6 (14.0%) | |
Algaithy et al. [30] | Eur J Surg Oncol | 2012 | 50 | 13 (26.0%) | 0 | Smoking, young age (< 45), incision type, thin areolar flap (< 5 mm) |
Carlson et al. [12] | Breast J | 2014 | 71 | 20 (28.2%) | N/A | Incision site (peri-areolar), operation for cancer (requires additional subareolar excision and frozen section to exclude disease) |
Chirappapha et al. [31] | Plast Reconstr Surg Global Open | 2014 | 124 | 19 (15.3%) | 4 (3.5%) | Volume of breast removed |
Colwell et al. [32] | Plast Reconstr Surg | 2014 | 482 | N/A | 21 (4.4%) | Preoperative radiotherapy, implant volume for direct-to-implant, incision type |
Bertoni et al. [34] | Ann Surg Oncol | 2016 | 28 | N/A | 2 (7.1%) | |
Bahl et al. [23] | J Am Coll Surg | 2016 | 164 | 20 (12.2%) | 7 (4.27%) | Single blood supply to the breast on MRI |
Ahn et al. [11] | Eur J Surg Oncol | 2018 | 220 | 141 (64.1%) | 25 (11.4%) | Age, BMI, existence of ptosis, incision site (peri-areolar), reconstruction |
Odom et al. [20] | Plast Reconstr Surg | 2018 | 79 | 21 (26.5%) | 16 (20.2%) | Long operative time, lower whole breast fluorescent intensity, smoking, lower Karnofsky Performance Scale |
Daar et al. [25] | Plast Reconstr Surg | 2019 | 4645a (30 studies) | 4.62% | 2.49% | Incision site (peri-areolar) |
Agha et al. [16] | BJS Open | 2019 | 3015a (14 studies) | 15.0% | N/a | |
Kontos et al. [26] | J Plast Reconstr Aesthet Surg | 2020 | 30 | 4 (13.3%) | N/A | |
Park et al. [35] | Breast | 2020 | 290 | 45 (15.5%) | 25 (8.6%) | Incision site (peri-areolar), decreased tumor-nipple distance, increased breast weight |
Webb et al. [19] | Am J Surg | 2020 | 294 | 105 (35.7%) | 0 | Increased body mass index |
Houvenaeghel et al. [27] | Br J Surg | 2021 | 59 | 9 (15.0%) | 2 (3.0%) | Body weight, body mass index |
Lai et al. | Current study | Present | 441 | Grade 1 29 (6.6%) Grade 2 37 (8.4%) | Grade 3 4 (0.9%) | Age, incision type (peri-areolar), larger breast (specimen > 450 g) MRI: Single or dual blood supply not risk factor for NAC necrosis |