{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:49:18Z","timestamp":1791910158300,"version":"4.3.4"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":39,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Swedish Breast Cancer Association"},{"DOI":"10.13039\/501100011727","name":"Stockholm County Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011727","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","award":["2021-01657"],"award-info":[{"award-number":["2021-01657"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002794","name":"Swedish Cancer Society","doi-asserted-by":"publisher","award":["24-0790 SIA"],"award-info":[{"award-number":["24-0790 SIA"]}],"id":[{"id":"10.13039\/501100002794","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002794","name":"Swedish Cancer Society","doi-asserted-by":"publisher","award":["24 0892 SCIA"],"award-info":[{"award-number":["24 0892 SCIA"]}],"id":[{"id":"10.13039\/501100002794","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nipple-sparing mastectomy (NSM) offers superior cosmetic and patient-reported outcomes compared with skin-sparing mastectomy (SSM), although its oncological safety remains debated. This study evaluated recurrence and survival after NSM versus SSM in women with breast cancer receiving implant-based immediate breast reconstruction (IBR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The population-based Stockholm Breast Reconstruction Database, including all women with breast cancer who underwent implant-based IBR in Stockholm from 2005 to 2015, was reviewed. Data were collected from medical chart review and the National Quality Register for Breast Cancer. The primary outcomes were long-term local recurrence (LR) rates and overall survival (OS) after NSM versus SSM. Survival probabilities and hazard ratios (HR) with their 95% confidence interval (c.i.) were estimated with a maximum 12 years of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1687 patients registered in the database, this analysis included 1594 implant-based IBRs performed in 1537 women with primary breast cancer. Of these, 86.3% (1376 breasts) had SSM and 13.7% had NSM (218 breasts). The median follow-up was 75 months for SSM and 60 months for NSM. The use of NSM increased from 7.6% in 2005\u20132007 to 26.6% in 2014\u20132015 (P &amp;lt; 0.001). LR occurred in 50 breasts, 13 after NSM and 37 after SSM, with a 12-year cumulative incidence of 14.1% for NSM and 3.7% for SSM (P = 0.001). Among the 13 LRs after NSM, 4 (30.8%) were localized in or beneath the nipple\u2013areola complex. The unadjusted HR was 3.18 (95% c.i. 1.67 to 6.03) and remained significant in the multivariable analysis (HR 2.08; 95% c.i. 1.01 to 4.28). OS did not differ significantly (HR 0.74; 95% c.i. 0.38 to 1.44).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NSM was associated with an increased risk of LR compared with SSM, whereas no significant association with OS was observed. Whether these results can be attributed to more residual breast glandular tissue needs to be evaluated in further research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjsopen\/zrag114","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:57:55Z","timestamp":1783511875000},"source":"Crossref","is-referenced-by-count":0,"title":["Long-term oncological outcomes after nipple-sparing mastectomy and implant-based immediate breast reconstruction in a population-based cohort of breast cancer patients"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5320-0246","authenticated-orcid":false,"given":"Helena","family":"Sackey","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Department of Breast, Endocrine Tumours and Sarcoma, Karolinska Comprehensive Cancer Center, Karolinska University Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ira","family":"Oikonomou","sequence":"additional","affiliation":[{"name":"Department of Surgery, South General Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Reconstructive Plastic Surgery, Karolinska University Hospital , Stockholm ,","place":["Sweden"]},{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2600-3483","authenticated-orcid":false,"given":"Axel","family":"Frisell","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Department of Dermatology and Venerology, Karolinska University Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Coud\u00e9 Adam","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhirar","family":"Ansarei","sequence":"additional","affiliation":[{"name":"Department of Surgery, Capio St G\u00f6ran\u2019s Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6222-956X","authenticated-orcid":false,"given":"Martin","family":"Halle","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Department of Reconstructive Plastic Surgery, Karolinska University Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna L V","family":"Johansson","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Cancer Registry of Norway, Norwegian Institute of Public Health , Oslo ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9518-0902","authenticated-orcid":false,"given":"Jana","family":"de Boniface","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Department of Surgery, Capio St G\u00f6ran\u2019s Hospital , Stockholm 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