Nipple areola complex sparing mastectomy.

Area of Science:

• Oncology
• Plastic Surgery
• Surgical Oncology

Background:

• Breast-conservative therapy (BCT) is a standard treatment for early breast cancer (BC).
• Nipple-areola-complex sparing mastectomy (NSM) is the preferred conservative mastectomy when complete removal is necessary, preserving the nipple and areola.
• Cosmetic outcomes are increasingly important alongside oncologic control in BC treatment.

Purpose of the Study:

• To evaluate the outcomes of nipple-areola-complex sparing mastectomy (NSM).
• To present technical modifications of NSM to improve nipple preservation and cosmetic results, especially in higher-risk patients.
• To assess the oncologic safety and cosmetic satisfaction of NSM.

Main Methods:

• The study involved 252 nipple-areola-complex sparing mastectomy (NSM) procedures.
• Patient selection criteria were carefully considered, excluding those with large/ptotic breasts, prior scarring, or smoking history.
• Technical modifications were described to enhance nipple viability and cosmetic outcomes in at-risk individuals.

Main Results:

• Nipple-areola-complex sparing mastectomy (NSM) achieved excellent cosmetic results.
• Nipple or areolar necrosis is a known complication, necessitating careful surgical technique.
• Oncologic safety regarding nipple-areola-complex involvement in invasive breast cancer requires careful patient selection.

Conclusions:

• Nipple-areola-complex sparing mastectomy (NSM) is a valuable option for breast cancer treatment, balancing oncologic control with superior cosmetic results.
• Careful patient selection and surgical technique are crucial for minimizing complications like nipple necrosis.
• Technical modifications can expand the applicability of NSM to a broader range of patients, enhancing quality of life.