保留乳头乳晕复合体（NAC）在乳腺癌手术中可以提高患者的满意度和生活质量。对于与乳头距离小于2厘米的瘤灶，NSM的肿瘤学安全性仍存在问题。我们进行了系统回顾以确定进行NSM的患者中，TND < 2厘米是否与局部复发风险增加有关。我们纳入了有关进行NSM的TND从NAC小于2厘米的浸润性或原位乳腺癌的研究，并报告了局部复发率。LRR率根据TND进行分层，并在研究中综合。使用新卡斯尔-奥塔瓦标准评估队列研究的质量。由于报告生存结局的差异性，无法进行荟萃分析。我们确定了七项回顾性队列研究，涉及2295名患者，以及18项病例系列研究，涉及3507名患者。所有研究中，直接肿瘤侵犯NAC被视为禁忌症。在队列研究中，中位随访时间为31-112个月（范围14-204个月）。TND < 2厘米的队列没有明显较高的局部复发率。在病例系列中，有275名患者的TND < 2厘米。病例系列中的综合局部复发率为2.6%，中位随访时间为10.4-71个月（范围0-158个月）。我们的系统回顾没有确定TND < 2厘米作为局部复发的重要危险因素。NSM在合适选择的TND < 2厘米患者中似乎是肿瘤学安全的。考虑到NSM与皮肤保留乳房切除术相比能够提高生活质量，我们建议在适当选择的患者中选择NSM作为首选手术。©2023. Society of Surgical Oncology.

Preserving the nipple-areolar complex (NAC) in breast cancer surgery improves patient satisfaction and quality of life. The oncologic safety of NSM in tumors < 2 cm from the nipple remains in question. We conducted a systematic review to determine whether TND < 2 cm was associated with increased risk of LRR in patients undergoing NSM.We included studies of invasive or in situ breast cancer < 2 cm from NAC undergoing NSM which reported LRR rates. LRR rates were stratified by TND and culminated across studies. Cohort study quality was assessed using Newcastle-Ottawa Criteria. Meta-analysis was not possible due to heterogeneity in reporting survival outcomes.We identified seven retrospective cohort studies with 2295 patients and 18 case series with 3507 patients. Direct tumor involvement of NAC was considered an absolute contraindication to NSM in all studies. In cohort studies, median follow-up was 31-112 (range 14-204) months. Cohorts with TND < 2 cm did not have a significantly higher rate of LRR. Amongst case series, 275 patients had TND < 2 cm. Combined LRR in case series was 2.6%, with median follow-up 10.4-71 (range 0-158) months.Our systematic review did not identify TND < 2 cm as a significant risk factor for LRR. NSM appears oncologically safe in select patients with TND < 2 cm. Given the improved quality of life associated with NSM compared to skin-sparing mastectomy, we suggest NSM as the procedure of choice in appropriately selected patients.© 2023. Society of Surgical Oncology.