World Journal of Surgery

, Volume 30, Issue 8, pp 1410–1413 | Cite as

Necrotic Complications after Nipple- and Areola-Sparing Mastectomy

  • Andrzej L. KomorowskiEmail author
  • Vittorio Zanini
  • Lea Regolo
  • Adriana Carolei
  • Wojciech M. Wysocki
  • Alberto Costa



The objective was to analyze the frequency and factors influencing necrotic complication in female patients undergoing nipple- and areola-sparing mastectomy.

Summary and background data

Nipple- and areola-sparing mastectomy has recently been shown to yield satisfactory results in a carefully selected group of breast cancer patients. The technique includes extensive undermining of the nipple–areola complex, which may result in an increased rate of necrotic complications. We report our early experience with necrotic changes after nipple- and areola-sparing mastectomy.


The medical records of 38 patients undergoing nipple- and areola-sparing mastectomy were analyzed retrospectively.


Mean age of the patient was 44.5 years (range 26–65). Necrotic complications occurred in 15.8% of patients and included: skin flap necrosis (1 case), partial nipple–areola complex necrosis (2 cases), and complete nipple–areola complex necrosis (3 cases). Two cases of capsular contraction were also recorded. Statistical analysis showed age below 45 years to be associated with a lower risk of necrotic complications (OR 4.51, P < 0.05).


The nipple- and areola-sparing mastectomy, although resulting in a relatively high frequency of necrotic complications, is a valuable surgical option for patients with small, peripheral tumors and for women undergoing prophylactic mastectomy. The procedure seems to be safer for women under 45 years of age.


Breast Reconstruction Prophylactic Mastectomy Positive Sentinel Node Capsular Contracture Sentinel Node Procedure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This work has been supported by a UICC International Cancer Technology Transfer Fellowship and with Federal funds from the National Cancer Institute, National Institutes of Health, under Contract NO2-CO-91012.


  1. 1.
    Gerber B, Krause A, Reimer T, et al. Skin-sparing mastectomy with conservation of the nipple–areola complex and autologous reconstruction is an oncologically safe procedure. Ann Surg 2003;238:120–127PubMedCrossRefGoogle Scholar
  2. 2.
    Mustonen P, Lepisto J, Paap A, et al. The surgical and oncological safety of immediate breast reconstruction. Eur J Surg Oncol 2004;30:817–823PubMedGoogle Scholar
  3. 3.
    Simmons RM, Hollenbeck ST, LaTrenta GS. Two-year follow-up of areola-sparing mastectomy with immediate reconstruction. Am J Surg 2004;188:403–406PubMedCrossRefGoogle Scholar
  4. 4.
    Simmons RM, Brennan M, Christos P, et al. Analysis of nipple/areolar involvement with mastectomy: can the areola be preserved? Ann Surg Oncol 2002;9(2):165–168PubMedCrossRefGoogle Scholar
  5. 5.
    Cense HA, Rutgers EJTh, Lopes Cardozo M, et al. Nipple-sparing mastectomy in breast cancer: a viable option? Eur J Surg Oncol 2001;27:521–526PubMedCrossRefGoogle Scholar
  6. 6.
    Mortenson MM, Schneider PD, Khatri VP, et al. Immediate breast reconstruction after mastectomy increases wound complications. Arch Surg 2004;139:988–991PubMedCrossRefGoogle Scholar
  7. 7.
    Crowe JP, Kim JA, Yetman R, et al. Nipple-sparing mastectomy. Technique and results of 54 procedures. Arch Surg 2004;139:148–150PubMedCrossRefGoogle Scholar
  8. 8.
    Petit JY, Veronesi U, Orecchia R, et al. The nipple sparing mastectomy: early results of a feasibility study of a new application of perioperative radiotherapy (ELIOT) in the treatment of breast cancer when mastectomy is indicated. Tumori 2003;89:288–291PubMedGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2006

Authors and Affiliations

  • Andrzej L. Komorowski
    • 1
    • 4
    Email author
  • Vittorio Zanini
    • 2
  • Lea Regolo
    • 2
  • Adriana Carolei
    • 3
  • Wojciech M. Wysocki
    • 1
  • Alberto Costa
    • 2
  1. 1.Department of Surgical OncologyMaria Skłodowska-Curie Memorial Institute of Oncology, Cancer CentreKrakowPoland
  2. 2.Department of Breast and Reconstructive SurgeryFondazione Salvatore MaugeriPaviaItaly
  3. 3.Department of Applied Health SciencesPavia UniversityPaviaItaly
  4. 4.Department of Surgical OncologyMaria Skłodowska-Curie Memorial Institute of Oncology, Cancer CentreKrakowPoland

Personalised recommendations