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