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Nipple-Areolar Complex-Sparing Mastectomy: Feasibility, Patient Selection, and Technique

Abstract

Background

We assessed the feasibility, patient selection, and technique of nipple-areolar c omplex (NAC)-sparing mastectomy. This dynamic article includes a video that demonstrates that sentinel node biopsy or axillary dissection can be performed through the mastectomy incisions or through a separate axillary incision.

Methods

The University of Texas M. D. Anderson Cancer Center initiated a prospective study investigating the feasibility of performing NAC-sparing mastectomy in the setting of prophylaxis and breast cancer treatment. Patients selected were at low risk for skin/NAC necrosis and NAC involvement with tumor.

Results

Preliminary results of 54 breasts that underwent NAC-sparing mastectomy showed a NAC necrosis rate of 7.2%. One patient who underwent NAC-sparing prophylactic mastectomy was found to have ductal carcinoma-in-situ that was not present at the nipple base. At a median follow-up of 15 months, there has been no NAC recurrence, which is similar to other reported series of 0% to 2%. Results were comparable with other small prospective series.

Conclusions

NAC-sparing mastectomy can be performed effectively while maintaining NAC viability. The risk of leaving residual breast tissue or occult tumor with the NAC is probably low if margin assessment is performed at the base or central core of the NAC. Long-term follow-up is forthcoming on these procedures. To achieve optimal cosmetic results with oncologic safety, NAC-sparing mastectomy should only be performed in carefully selected patients.

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Conflict of interest

The authors declare no conflict of interest.

Author information

Correspondence to Gildy Babiera MD.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Technique of nipple-areolar complex-sparing mastectomy. Photo courtesy of R.S. (MPG 46481 kb)

Technique of nipple-areolar complex-sparing mastectomy. Photo courtesy of G.B. (AVI 27597 kb)

Technique of nipple-areolar complex-sparing mastectomy. Photo courtesy of R.S. (MPG 46481 kb)

Technique of nipple-areolar complex-sparing mastectomy. Photo courtesy of G.B. (AVI 27597 kb)

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Babiera, G., Simmons, R. Nipple-Areolar Complex-Sparing Mastectomy: Feasibility, Patient Selection, and Technique. Ann Surg Oncol 17, 245–248 (2010). https://doi.org/10.1245/s10434-010-1256-0

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Keywords

  • Sentinel Lymph Node Biopsy
  • Nipple
  • Occult Tumor
  • Margin Assessment
  • Subcutaneous Mastectomy