Table 2.
Factors associated with nipple-areolar complex (NAC) and skin necrosis
| Characteristics | Nipple-areola complex Ischemia necrosis |
Nipple-areola complex Ischemia necrosis or skin flap necrosis |
|||||
|---|---|---|---|---|---|---|---|
| Total (n = 441) | Yes (n = 41) | No (n =4 00) | p-value | Yes (n = 54) | No (n = 387) | p-value | |
| Age | 49.1 ± 9.8 | 53 ± 10.7 | 48.7 ± 9.6 | < 0.01 | 51.2 ± 10.7 | 48.8 ± 9.6 | 0.09 |
| BMI | 23 ± 3.5 | 23.9 ± 4.3 | 23.0 ± 3.4 | 0.16 | 23.9 ± 4.1 | 22.9 ± 3.4 | 0.09 |
| BMI | 0.19 | 0.08 | |||||
| BMI < 27 | 384 (87.1) | 33 (80.5) | 351 (87.8) | 43 (11.2) | 341 (88.8) | ||
| BMI ≥ 27 | 57 (12.9) | 8 (19.5) | 49 (12.3) | 11 (19.3) | 46 (80.7) | ||
| Reconstruction | 0.10 | 0.02 | |||||
| Yes | 369 (83.7) | 38 (92.7) | 331 (82.8) | 51 (94.4) | 318 (82.2) | ||
| No | 72 (16.3) | 3 (7.3) | 69 (17.3) | 3 (5.6) | 69 (17.8) | ||
| Reconstruction type | 0.62 | 0.57 | |||||
| Tissue expander | 9 (2.4) | 0 (0.0) | 9 (2.7) | 0(0.0) | 9 (2.83) | ||
| Gel implant | 321 (87.0) | 36 (94.7) | 285 (86.1) | 45 (88.24) | 276 (86.79) | ||
| TRAM Flap | 33 (8.9) | 2 (5.3) | 31 (9.4) | 6 (11.76) | 27 (8.49) | ||
| LD flap + gel implant | 2 (0.5) | (0.0) | 2 (0.6) | 0 (0.0) | 2 (0.63) | ||
| LD flap | 4 (1.1) | (0.0) | 4 (1.2) | 0 (0.0) | 4 (1.26) | ||
| Specimen | 337.6 ± 207.3 | 427.2 ± 235.5 | 328.2 ± 202.2 | < 0.01 | 432.8 ± 224.1 | 324.0 ± 201.5 | < 0.01 |
| Specimen | 0.03 | < 0.01 | |||||
| < 180 | 70 (16.2) | 3 (7.3) | 67 (17.1) | 3 (5.6) | 67 (17.7) | ||
| 180–320 | 174 (40.3) | 12 (29.3) | 162 (41.4) | 16 (29.6) | 158 (41.8) | ||
| 320–450 | 105 (24.3) | 12 (29.3) | 93 (23.8) | 15 (27.8) | 90 (23.8) | ||
| > 450 | 83 (19.2) | 14 (34.1) | 69 (17.6) | 20 (37.0) | 63 (16.7) | ||
| Tumor-nipple distance | 3.2 ± 1.8 | 3.4 ± 1.6 | 3.1 ± 1.8 | 0.41 | 3.7 ± 1.7 | 3.1 ± 1.8 | 0.04 |
| Neoadjuvant CT | 0.04 | 0.13 | |||||
| Yes | 46 (15.2) | 1 (3.0) | 45 (16.7) | 3 (7.3) | 43 (16.5) | ||
| No | 256 (84.8) | 32 (97.0) | 224 (83.3) | 38 (92.7) | 218 (83.5) | ||
| ER | 0.62 | 0.78 | |||||
| Positive | 289 (81.4) | 29 (78.4) | 260 (81.8) | 40 (80.0) | 209 (69.2) | ||
| Negative | 66 (18.6) | 8 (21.6) | 58 (18.2) | 10 (20.0) | 93 (30.8) | ||
| PR | 0.96 | 0.49 | |||||
| Positive | 246 (69.9) | 26 (70.3) | 220 (69.8) | 37 (74.0) | 219 (85.0) | ||
| Negative | 106 (30.1) | 11 (29.7) | 95 (30.2) | 13 (26.0) | 93 (87.7) | ||
| HER-2 | 0.94 | 0.84 | |||||
| Positive | 83 (27) | 9 (26.5) | 74 (27.1) | 13 (28.3) | 70 (26.8) | ||
| Negative | 224 (73) | 25 (73.5) | 199 (72.9) | 33 (71.7) | 191 (73.2) | ||
| Stage | 0.58 | 0.28 | |||||
| Stage 0 | 82 (22.7) | 8 (20.5) | 74 (23) | 9 (17.3) | 73 (23.6) | ||
| Stage 1 | 95 (26.3) | 9 (23.1) | 86 (26.7) | 12 (23.1) | 83 (26.9) | ||
| Stage 2 | 151 (41.8) | 20 (51.3) | 131 (40.7) | 28 (18.5) | 123 (39.8) | ||
| Stage 3 | 33 (9.1) | 2 (5.1) | 31 (9.6) | 28 (53.8) | 30 (9.7) | ||
| Skin incision | < 0.01 | < 0.01 | |||||
| Upper outer oblique (radial) | 83 (18.9) | 5 (12.2) | 78 (19.5) | 12 (22.2) | 71 (18.4) | ||
| Peri-areolar | 107 (24.3) | 21 (51.2) | 86 (21.6) | 24 (44.4) | 83 (21.5) | ||
| Single axillary | 243 (55.2) | 15 (36.6) | 228 (57.1) | 18 (33.3) | 225 (58.3) | ||
| Infra-mammary + axillary | 7 (1.6) | 0 (0.0) | 7 (1.8) | 0 (0.0) | 7 (1.8) | ||