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Updated: Jul 9, 2026
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
[Prophylactic mastectomies and immediate breast reconstruction in patients at very high genetic risk: our experience
1Unité de chirurgie carcinologique et reconstructrice mammaire, institut Gustave-Roussy, 39, rue Camille-Desmoulins, 94800 Villejuif, France. marie-christine.missana@orange.fr
Aims:
Prophylactic mastectomy has been the subject of major publications by international groups. Its oncology benefit is undisputed in patients with a genetic mutation. Nevertheless, its impact on quality of life, its psychological, esthetic, sexual, functional and pain repercussions are such that it should not and must never be programmed in an emergency situation. We report our experience with 14 patients at very high genetic risk having undergone a bilateral prophylactic mastectomy with immediate breast reconstructive surgery.
Methods:
From 1 March 2001 to 31 March 2006, 14 patients at very high genetic risk, seven of whom had a history of breast cancer, underwent immediate breast reconstruction with skin sparing mastectomy and preservation of the nipple-areolar complex.
Results:
In 71.5% of the cases, we obtained a definitive conservation of the nipple-areolar complex, with esthetic results judged very satisfying.
Conclusion:
Immediate bilateral breast reconstruction by provisional or definitive implant with conservation of the skin flap and the nipple-areolar complex may constitute a positive radical issue for requesting and motivated patients at high genetic risk, managed by a multidisciplinary team.
