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Updated: Mar 26, 2026
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Preoperative digital mammography imaging in conservative mastectomy and immediate reconstruction
Alberto Rancati1, Claudio Angrigiani1, Dennis Hammond1
11 Director of Oncoplastic Surgery, IOHM, Buenos Aires, Argentina ; 2 Chief, Division of Plastic Surgery, Hospital Santojani, Buenos Aires, Argentina ; 3 Private Practice, Partners in Plastic Surgery, Grand Rapids, MI, USA ; 4 Private Practice, Milano, Italy ; 5 Chief, Mastology Division, Institute A. Roffo, Buenos Aires, Argentina ; 6 Presidente Fundacion Argentina Contra el Cancer, FACEC, Buenos Aires, Argentina, 7 General Director, IOHM, Buenos Aires, Argentina.
Background:
Digital mammography clearly distinguishes gland tissue density from the overlying non-glandular breast tissue coverage, which corresponds to the existing tissue between the skin and the Cooper's ligaments surrounding the gland (i.e., dermis and subcutaneous fat). Preoperative digital imaging can determine the thickness of this breast tissue coverage, thus facilitating planning of the most adequate surgical techniques and reconstructive procedures for each case.
Methods:
This study aimed to describe the results of a retrospective study of 352 digital mammograms in 176 patients with different breast volumes who underwent preoperative conservative mastectomies. The breast tissue coverage thickness and its relationship with the breast volume were evaluated.
Results:
The breast tissue coverage thickness ranged from 0.233 to 4.423 cm, with a mean value of 1.952 cm. A comparison of tissue coverage and breast volume revealed a non-direct relationship between these factors.
Conclusions:
Preoperative planning should not depend only on breast volume. Flap evaluations based on preoperative imaging measurements might be helpful when planning a conservative mastectomy. Accordingly, we propose a breast tissue coverage classification (BTCC).
