Nipple-sparing Mastectomy has Low Cancer Recurrence Rate

Nipple-sparing mastectomy had been controversial for the past decade.  Recently, a study showed that women who underwent nipple-sparing mastectomy had low breast cancer recurrence.  The study which was published in the Journal of American College of Surgeons revealed an overall cancer recurrence of 5.5 % at a median follow-up of 55 months.  No cancer recurrence occured in the retained nipple.

The study also showed that the disease-free survival rate was also high (95.7% ar 3 years and 92.3% at 5 years.)  Locoregional recurrence was 3.7% with no recurrence occured in the nipple.

Indications of Nipple Sparing Mastectomy

• Tumor size <3 cm
• Tumor >2 cm away from the nipple
• No axillary nodal involvement or negative Sentinel Lymph Node
• No skin involvement of Paget's disease
• Intraop and frozen section pathology of the breast tissue underneath the NAC are negative
• Pre-operative MRI imaging showed no nipple-areolar involvement

Breast reconstruction after Nipple-sparing Mastectomy

• Breast tissue expander followed by permanent breast implant placement
• Autologous reconstruction, such as DIEP flap
• Direct-implant reconstruction

Reference:  Oncologic Safety of Nipple Sparing Mastectomy in Women with Breast Cancer, Journal of the American College of Surgeons. DOI: http://dx.doi.org/10.1016/j.jamcollsurg.2017.06.013.

Emmanuel De La Cruz MD, PLLC

Plastic Surgeon, Houston texas