Nipple-sparing mastectomy

Nipple-Sparing Mastectomy

Breast reconstruction following nipple-sparing mastectomy

A nipple-sparing mastectomy (NSM) is a surgical procedure for the treatment or prevention of breast cancer that involves the removal of breast tissue while preserving the nipple-areolar complex (NAC). This technique is designed to improve cosmetic outcomes and patient satisfaction by maintaining the natural appearance of the breast.

Indications

Nipple-sparing mastectomy is typically indicated for patients with early-stage breast cancer or those at high risk of developing breast cancer, such as individuals with BRCA1 or BRCA2 mutations. It is also considered for patients undergoing prophylactic mastectomy to reduce cancer risk. The suitability of NSM depends on factors such as tumor size, location, and the absence of cancerous involvement of the nipple.

Surgical Technique

The procedure involves making an incision in the breast, often in a location that minimizes visible scarring, such as along the inframammary fold or around the areola. The breast tissue is carefully removed while preserving the skin envelope and the NAC. Surgeons may use intraoperative techniques to assess the viability of the nipple and ensure that cancerous cells are not present in the tissue beneath the nipple.

Incision of breast during nipple-sparing mastectomy

Reconstruction Options

Following the removal of breast tissue, immediate breast reconstruction is often performed. Options for reconstruction include the use of breast implants or autologous tissue reconstruction, such as the DIEP flap or TRAM flap. The choice of reconstruction method depends on patient preference, body type, and medical considerations.

Benefits and Risks

The primary benefit of nipple-sparing mastectomy is the preservation of the nipple, which can lead to improved aesthetic outcomes and higher patient satisfaction. However, there are risks associated with the procedure, including the potential for nipple necrosis, loss of sensation, and the possibility of residual cancerous tissue in the preserved NAC.

Outcomes

Studies have shown that NSM can be oncologically safe for selected patients, with recurrence rates comparable to those of traditional mastectomy. Patient satisfaction is generally high, particularly regarding the cosmetic results and the psychological benefits of preserving the nipple.

Related Pages

• Mastectomy
• Breast reconstruction
• Breast cancer
• Prophylactic mastectomy