BACKGROUND: Even without comparative trials, nipple-sparing mastectomy (NSM) is gaining traction in the treatment of established breast cancer and in the prophylactic setting. As yet, there are no established techniques that are universally applied to NSM. Herein we describe our surgical approach. METHODS: All mastectomies performed by a single surgeon (AJS). Reconstructions performed included synthetic implants, deep inferior epigastric (DIEP) and gluteal artery perforator flaps (GAP). A lateral incision (12.1%) and a 6:00 radial incision (87.9%) were used in all patients. The areola was elevated just beneath the deep dermis and ductal tissue within the nipple papilla was "cored". RESULTS: Fifty-eight patients underwent 82 NSMs for both cancer and prophylaxis. No patient developed necrosis of the nipple-areola complex (NAC). Minor skin-edge necrosis not involving the NAC occurred in 2 patients. Four patients developed a hematoma, 2 requiring re-operation. One patient required re-operation to correct a vein problem. There were no flap losses. CONCLUSIONS: NSM can be performed with a minimal incidence of skin-flap related complications. In our hands, radial incisions perform well in this regard. Indications for NSM and the optimal technique are yet to be determined.
BACKGROUND: Even without comparative trials, nipple-sparing mastectomy (NSM) is gaining traction in the treatment of established breast cancer and in the prophylactic setting. As yet, there are no established techniques that are universally applied to NSM. Herein we describe our surgical approach. METHODS: All mastectomies performed by a single surgeon (AJS). Reconstructions performed included synthetic implants, deep inferior epigastric (DIEP) and gluteal artery perforator flaps (GAP). A lateral incision (12.1%) and a 6:00 radial incision (87.9%) were used in all patients. The areola was elevated just beneath the deep dermis and ductal tissue within the nipple papilla was "cored". RESULTS: Fifty-eight patients underwent 82 NSMs for both cancer and prophylaxis. No patient developed necrosis of the nipple-areola complex (NAC). Minor skin-edge necrosis not involving the NAC occurred in 2 patients. Four patients developed a hematoma, 2 requiring re-operation. One patient required re-operation to correct a vein problem. There were no flap losses. CONCLUSIONS: NSM can be performed with a minimal incidence of skin-flap related complications. In our hands, radial incisions perform well in this regard. Indications for NSM and the optimal technique are yet to be determined.
Authors: Markus Niemeyera; Johannes Ettla; Birgit Plattnera; Rainer Schmida; Daniel Müllerb; Hans-Günther Machensb; Marion Kiechlea; Stefan Paepkea Journal: Breast Care (Basel) Date: 2010-08-06 Impact factor: 2.860
Authors: Elizabeth B Odom; Rajiv P Parikh; Grace Um; Simone W Kantola; Amy E Cyr; Julie A Margenthaler; Marissa M Tenenbaum; Terence M Myckatyn Journal: Plast Reconstr Surg Date: 2018-07 Impact factor: 4.730
Authors: M G Valero; T-A Moo; S Muhsen; E C Zabor; M Stempel; A Pusic; M L Gemignani; M Morrow; V Sacchini Journal: Br J Surg Date: 2020-05-20 Impact factor: 6.939
Authors: Jamie L Wagner; Regina Fearmonti; Kelly K Hunt; Rosa F Hwang; Funda Meric-Bernstam; Henry M Kuerer; Isabelle Bedrosian; Melissa A Crosby; Donald P Baumann; Merrick I Ross; Barry W Feig; Savitri Krishnamurthy; Mike Hernandez; Gildy V Babiera Journal: Ann Surg Oncol Date: 2011-10-07 Impact factor: 5.344
Authors: Vinay Rawlani; Julia Fiuk; Sarah A Johnson; Donald W Buck; Elliot Hirsch; Nora Hansen; Seema Khan; Neil A Fine; John Ys Kim Journal: Can J Plast Surg Date: 2011