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Surgeons Report Experience with Nipple Sparing Mastectomy

Nipple sparing mastectomy, a technique that preserves the nipple and surrounding tissues, is an effective technique for breast reconstruction. According to a study by plastic surgeons at Georgetown University Hospital, there’s no evidence that the procedure increases risk of cancer recurrence.

In nipple-sparing mastectomy, the nipple and surrounding tissues are preserved for use in breast reconstruction, which is generally performed immediately after mastectomy.

From 1989 to 2010, plastic surgeon Scott Spear, MD and colleagues at Georgetown report their hospital’s experience with nipple-sparing mastectomy. They performed 162 nipple-sparing mastectomies in 101 women.

Thirty percent of the operations were performed for treatment of diagnosed breast cancer, while the remaining 70 percent of nipple-sparing mastectomies were performed on women at high risk of breast cancer undergoing preventive mastectomy.

Potential Benefits of the Nipple Sparing Mastectomy

Nipple-sparing mastectomy could offer important benefits for patient satisfaction and body image, as well as fewer procedures and complications. Plastic surgeons have been slow to adopt the technique because of perceived safety risks, especially the concern that the preserved breast tissue might contain cancerous cells. To address these concerns, Dr. Spear and colleagues sought to provide objective data on the risks and outcomes of nipple-sparing mastectomy.

They say that a biopsy is the key to detecting cancer cells. Before breast reconstruction, the doctors analyzed a sample of the tissue from under the nipple. In ten percent of the biopsies of the patients undergoing preventive mastectomy, evidence of breast cancer cells was detected. In these cases, the nipple was not used in breast reconstruction.

In other patients, biopsies detected no evidence of cancer, and the tissues were used for breast reconstruction. At an average follow-up of more than three years, there were no recurrent cancers of the nipple-areola complex in women undergoing therapeutic mastectomy, and no primary cancers in women undergoing preventive mastectomy.

According to the authors, these findings support the previous findings that the long-term risk of cancer developing in the nipple and surrounding tissues after nipple-sparing mastectomy is “zero or near-zero.”

Video: Who’s a Good Candidate for Nipple Sparing Mastectomy?

Surgical oncologist Dr. Richard Gray explains the nipple-sparing mastectomy procedure and which patients may be candidates for this procedure.

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