Nipple Sparing Mastectomy
A mastectomy is a surgical procedure to remove the breast in patients with breast cancer, as well as those who wish to prevent the disease from occurring. This is one of the most commonly used and most effective treatment options for breast cancer, as it effectively removes all traces of cancer and reduces a patient’s risk of recurrence.
Under certain circumstances, nipple/areola sparing mastectomy is possible. The most common candidates for nipple-sparing mastectomy are patients having prophylactic mastectomy for the BRCA gene or strong family history of breast cancer. Some patients with small or early breast cancers that are not close to the nipple/areola complex are also candidates for nipple/areola sparing surgery. The patient needs to discuss the indications for nipple/areola sparing surgery with her breast oncologic surgeon. If the breast oncologic surgeon feels that nipple/areola sparing surgery is indicated, Drs Karp and Choi offer both implant and autologous (use your own tissue) options to reconstruct the breast. The reconstruction process is easier as the nipple/areola will not need to be recreated. However, it is important for patients to note that leaving the nipple intact also leaves a very small amount of breast tissue, which may be at risk for developing cancer.
Nipple-Sparing Mastectomy Procedure
During a nipple-sparing mastectomy, the incision location is decided by both the breast oncologic surgeon and Drs Karp or Choi. Multiple incision locations are possible based on the patient’s clinical situation and anatomy. The breast tissue is then taken out, removing tissue as close to the nipple/areola as possible to ensure that all potentially cancerous cells are removed. Cancer should be a minimum of two centimeters away from the tissue in the area of the areola. Patients whose breast cancer affects their nipple/areola are not candidates for this procedure.
This procedure is performed under general anesthesia in a hospital setting. Patients may choose to undergo breast reconstruction during the same procedure in order to reduce the need for additional surgery and to be able to wake up from surgery with a new breast mound. Reconstruction may include the placement of an implant or tissue flap. These procedures are discussed under the breast reconstruction area of this website.
Recovery from Nipple-Sparing Mastectomy
Mastectomy usually requires a one to two day hospital stay, depending on the extent of the procedure. If a flap procedure is performed to reconstruct the breast, the hospital stay will be longer. A drain will be attached to the chest to collect fluid, and will be removed by your doctor at a later date. Most women are able to recover well from this procedure.
Although nipple-sparing mastectomy offers patients many aesthetic and emotional advantages, patients will likely lose sensation in the nipple, as the nerves connected to the area are removed during this procedure. Some women claim to still maintain some sensation after surgery, but accurate results are not yet available.
Nipple-Sparing Mastectomy Risks
As with any type of surgery, there are certain risks associated with the mastectomy procedure. Some of these risks may include: Blood clots, infection, breathing problems, blood loss, skin loss, shoulder pain and stiffness. The risks are small and depend on the procedure chosen for reconstruction. Drs Karp or Choi will discuss these risks at your consultation.
The nipple may also be moved to a different position and may suffer wound healing complications as a result of this procedure. Drs. Karp or Choi will discuss this risks with you, as well as take the time to address any concerns you may have before surgery. Call us today to learn more about our advanced nipple-sparing technique to help enhance a patient’s physical and emotional well-being after breast cancer.