• BBSG – Brazilian Breast Study Group


Mastectomy is the surgical removal of the mammary gland: it is the first effective treatment described for breast cancer and is used up to the present day. Simple mastectomy refers only to breast removal, while radical mastectomies are associated with axillary lymph node dissection (ALND). Surgical procedures that preserve the skin or the areola-papillary complex (APC) are called sparing or preserving mastectomies, often described in English as skin-sparing mastectomy (SSM) and nipple-sparing mastectomy (NSM) or adeno-mastectomies.


Breast cancer surgery Radical mastectomy Ski-sparing mastectomy Nipple-sparing mastectomy Local recurrence 

Recommended Reading

  1. 1.
    De La Cruz L, Moody A, Tappy E, Blankenship S, Hecht E. Overall survival, disease-free survival, local recurrence, and nipple-areolar recurrence in the setting of nipple-sparing mastectomy: a meta-analysis and systematic review. Ann Surg Oncol. 2015;22:3241–9. Meta-analysis of NSM studies demonstrating the oncological safety of the procedure.CrossRefGoogle Scholar
  2. 2.
    Gerber B, Krause A, Dieterich M, Kundt G, Reimer T. The Oncological Safety of Skin Sparing Mastectomy with Conservation of the Nipple-Areola Complex and Autologous Reconstruction: An Extended Follow-Up Study. Ann Surg. 2009;249:461–8. Cohort with 40 SSM, 60 NSM and 130 conventional mastectomies in patients with similar staging. The rates of local recurrence after 101 months were respectively 10.4%, 11.7% and 11.5%.CrossRefGoogle Scholar
  3. 3.
    Halsted WS. The results of radical operations for cure of cancer of the breast. Ann Surg. 1907;46:1–19. First report on radical mastectomy. In a series of 50 cases followed up for 2 years, there were only 3 local recurrences. These results are far superior to the techniques described aboveCrossRefGoogle Scholar
  4. 4.
    Jy P, Veronesi U, Orecchia R, Curigliano G, Rey PC, Botteri E, et al. Risk factors associated with recurrence after nipple-sparing mastectomy for invasive and intraepithelial neoplasia. Ann Oncol. 2012;23:2053–8. Cohort of 934 NSM cases with intraoperative radiotherapy on APC followed up for 50 months. There were 772 cases of ICD, with 3.6% of local recurrences and 0.8% of recurrences in APC. The cases of DCIS were 162, with 4.9% of local recurrence and 2.9% of recurrence in APC.CrossRefGoogle Scholar
  5. 5.
    Murthy V, Chamberlain RS. Defining a place for nipple sparing mastectomy in modern breast care: an evidence based review. Breast J. 2012:1–11. Evidence-based review of NSM. The occurrence of occult disease in the mean APC is about 15% to 20%. However, the number of clinical recurrences observed is around 4%, with less than 2% recurrence in APC. The number of necrosis of APC varies between 0% and 7%.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • BBSG – Brazilian Breast Study Group
    • 1
  1. 1.BBSGSao PauloBrazil

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