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Updated: Jun 27, 2026
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Nipple-sparing mastectomy update: one hundred forty-nine procedures and clinical outcomes
Joseph P Crowe1, Rebecca J Patrick, Randall J Yetman
1Department of General Surgery, Cleveland Clinic Foundation, 9500 Euclid Ave, A80, Cleveland, OH 44195, USA. crowej@ccf.org
Objectives:
To describe our experience with patients who underwent the nipple-sparing mastectomy procedure developed and standardized at our institution and to report clinical outcomes for those patients with a breast cancer diagnosis.
Design:
Prospective study for consecutive nipple-sparing mastectomy procedures.
Setting:
Multidisciplinary breast center at a large tertiary care facility.
Patients:
One hundred ten consecutive patients underwent nipple-sparing mastectomy between July 2001 and June 2007.
Intervention:
Nipple-sparing mastectomy was offered to carefully screened patients; the nipple-areola tissue was cored and sent for histologic frozen-section analysis intraoperatively.
Main Outcome Measures:
Assessment of nipple-areola cored tissue for neoplastic involvement; postoperative stability of retained nipple-areola complex; and clinical outcomes.
Results:
Data were available for 149 nipple-sparing mastectomies performed on 110 patients. No procedure performed for prevention had neoplastic involvement of the cored nipple-areola tissue, while 9 procedures performed for breast cancer treatment were found to have neoplastic involvement. Postoperatively, 2 patients had partial loss of the nipple-areola complex due to sloughing and a third patient developed an infection that required surgical removal of the nipple-areola complex. Among patients with breast cancer, none with ductal carcinoma in situ has developed a recurrence, while 4 patients with infiltrating breast cancer have, including 2 patients with distant metastases only, a third with a chest wall recurrence, and a fourth with an axillary recurrence.
Conclusion:
A low incidence of neoplastic involvement of the nipple-areola cored tissue leads to successful completion of nipple-sparing mastectomy for most patients.
