, Volume 17, Issue 1, pp 323-324
Date: 24 Sep 2009

Nipple-Sparing Mastectomy: Overcoming Oncological Outcomes Challenges

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To the Editors:

Many women are undergoing surgery for breast cancer with the probability of nipple preservation. Cosmetic outcome and patient satisfaction following nipple-sparing mastectomy (NSM) are thought to be superior to after standard mastectomy. So, why is NSM still considered experimental? What are the oncological concerns about, the technical demands of, and the indications for NSM?

To shed light on this issue, Voltura and colleagues performed a retrospective study on 34 selected patients who underwent NSM, published recently in the Annals of Surgical Oncology.1 On the basis of promising data from this study, the authors conclude that, with careful clinical selection of patients and careful pathological evaluation of nipple–areolar complex (NAC) at surgery, NSM can be an oncologically safe procedure in patients who prefer this technique and consider it important to their quality of life.

Concerns regarding NSM are focused predominantly on the probability of residual cancer cells ...