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Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Technical considerations in nipple-sparing mastectomy: 82 consecutive cases without necrosis
Alan J Stolier1, Scott K Sullivan, Frank J Dellacroce
1Department of Surgery, Tulane University, 2525 Severn Ave., Metairie, New Orleans, LA 70002, USA. astolier@tulane.edu
Annals of Surgical Oncology
|February 8, 2008
Summary
Nipple-sparing mastectomy (NSM) is a growing procedure for breast cancer and prophylaxis. This study shows NSM can be done with few skin-flap complications, particularly using radial incisions.
Area of Science:
- Oncology
- Surgical Oncology
- Plastic Surgery
Background:
- Nipple-sparing mastectomy (NSM) is increasingly utilized for breast cancer treatment and risk reduction.
- Standardized NSM techniques are not yet established.
- This study details a specific surgical approach to NSM.
Purpose of the Study:
- To describe a surgical technique for nipple-sparing mastectomy (NSM).
- To evaluate the complication rates associated with this NSM approach.
Main Methods:
- A retrospective review of 82 NSMs performed by a single surgeon.
- Reconstruction utilized synthetic implants or deep inferior epigastric (DIEP) and gluteal artery perforator (GAP) flaps.
- Incisions included lateral (12.1%) and radial (87.9%) approaches, with areolar elevation and nipple "coring".
Main Results:
- No nipple-areola complex (NAC) necrosis occurred in 58 patients undergoing 82 NSMs.
- Minor skin-edge necrosis (not involving NAC) in 2 patients.
- Hematoma in 4 patients (2 requiring re-operation); 1 re-operation for a vein issue. No flap losses.
Conclusions:
- NSM can achieve a low rate of skin-flap complications.
- Radial incisions were associated with favorable outcomes in this series.
- Further research is needed to define NSM indications and optimal techniques.
