{
  "abstract": "Introduction\n\nRisk-reducing mastectomy (RRM) for germline pathogenic variant (GPVs) carriers were historically performed as total mastectomy (TM) or skin-sparing mastectomy (SSM), although nipple-sparing mastectomy (NSM) has recently emerged as an oncologically safe RRM option.Methods\n\nThis retrospective cohort study included all female patients with confirmed BRCA1, BRCA2, PALB2, or other high-penetrance GPVs at two academic institutions in Canada between 2003 and 2024. Temporal trends in NSM uptake were assessed using the Mantel-Haenszel test for trend and multivariable logistic regression.Results\n\nAfter exclusions, 559 GPV carriers including 319 (57%) affected carriers and 240 (43%) unaffected carriers comprised the study cohort. The median age at RRM was 45 years old (range 22-76) and most were BRCA1 carriers (46.7%) or BRCA2 carriers (44.4%). Overall, 310 carriers (55.5%) underwent NSM, 174 (31.1%) underwent SSM, and 75 (13.4%) underwent TM. NSM uptake was highest among patients aged 40-49 years (56%) and lowest in those ≥ 60 years (42%, p = 0.03). Relative to unaffected carriers, affected carriers (47% vs. 66%, p < 0.001) and those with prior radiation were less likely to undergo NSM (34.3% vs. 62.7%, p < 0.001). A clear increase in NSM occurred over time, from 11.9% pre-2012 to 74.4% after 2022 (p < 0.001). Multivariable analysis adjusting for age, GPV, parity, menopausal status, and personal history of breast cancer identified normal BMI (OR 1.99, 95% CI 1.18-3.34), lack of radiation exposure (OR 3.03, 95% CI 1.76-5.23), and year of surgery as independent predictors of NSM receipt (OR 1.25, 95% CI 1.19-1.32).Conclusion\n\nThere has been a significant increase in NSM use among BRCA1/2, PALB2 and other GPV carriers over the last two decades.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Surgery, McGill University, Montreal, QC, Canada.",
    "Stroll Cancer Prevention Centre, Jewish General Hospital, Montreal, QC, Canada.",
    "Department of Plastic and Reconstructive Surgery, McGill University, Montreal, QC, Canada.",
    "Department of Oncology, McGill University, Montreal, QC, Canada.",
    "Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.",
    "Department of Human Genetics, McGill University, Montreal, QC, Canada.",
    "Department of Surgery, McGill University, Montreal, QC, Canada. sm.wong@mcgill.ca.",
    "Stroll Cancer Prevention Centre, Jewish General Hospital, Montreal, QC, Canada. sm.wong@mcgill.ca.",
    "Department of Oncology, McGill University, Montreal, QC, Canada. sm.wong@mcgill.ca.",
    "Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada. sm.wong@mcgill.ca.",
    "Segal Cancer Centre, Jewish General Hospital, 3755 Cote Ste Catherine, E713, Montreal, QC, H3T1E2, Canada. sm.wong@mcgill.ca."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Marya Alsuhaibani"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Amel Melanson"
    },
    {
      "affs": [
        2
      ],
      "name": "Alex Viezel-Mathieu"
    },
    {
      "affs": [
        2
      ],
      "name": "Tassos Dionisopoulos"
    },
    {
      "affs": [
        0,
        3,
        4
      ],
      "name": "Mark Basik"
    },
    {
      "affs": [
        0
      ],
      "name": "Jean Francois Boileau"
    },
    {
      "affs": [
        0
      ],
      "name": "Karyne Martel"
    },
    {
      "affs": [
        0,
        3
      ],
      "name": "Sarkis Meterissian"
    },
    {
      "affs": [
        2
      ],
      "name": "Joshua Vorstenbosch"
    },
    {
      "affs": [
        1
      ],
      "name": "Victor Villareal-Corpuz"
    },
    {
      "affs": [
        1,
        3,
        4,
        5
      ],
      "name": "William D Foulkes"
    },
    {
      "affs": [
        0,
        3,
        4
      ],
      "name": "Ipshita Prakash"
    },
    {
      "affs": [
        6,
        7,
        8,
        9,
        10
      ],
      "name": "Stephanie M Wong",
      "orcid": "0000-0002-6850-2192"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/esm0znmtws6ae.bib",
  "cited_by": 0,
  "doi": "10.1186/s13053-026-00351-0",
  "fulltext_url": "https://europepmc.org/articles/PMC13681777",
  "id": "esm0znmtws6ae",
  "issns": [
    "1731-2302",
    "1897-4287"
  ],
  "landing_url": "https://europepmc.org/article/MED/42902324",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "QH426-470"
    ],
    [
      "lcc",
      "RC254-282"
    ],
    [
      "openalex",
      "1311|BRCA gene mutations in cancer"
    ]
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  "openalex": "W7170750729",
  "pdf_url": "https://europepmc.org/articles/PMC13681777?pdf=render",
  "pmcid": "PMC13681777",
  "pmid": "42902324",
  "published": "2026-07-01",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/esm0znmtws6ae.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:41Z",
      "native_id": "MED:42902324",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42902324"
    },
    {
      "first_seen": "2026-10-30T13:46:33Z",
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      "url": "https://doi.org/10.1186/s13053-026-00351-0"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "openalex:1311|BRCA gene mutations in cancer",
      "subfield": "genetics-genomics"
    }
  ],
  "title": "Trends in the uptake of nipple sparing mastectomy in BRCA1/2, PALB2 and other pathogenic variant carriers undergoing risk reducing mastectomy.",
  "title_text": "Trends in the uptake of nipple sparing mastectomy in BRCA1/2, PALB2 and other pathogenic variant carriers undergoing risk reducing mastectomy.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:46:33Z",
  "url": "https://research.draconitic.com/paper/esm0znmtws6ae",
  "venue": "Hereditary cancer in clinical practice",
  "versions": []
}