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Related Concept Videos

The Mammary Glands01:12

The Mammary Glands

876
The female breast is a hemispheric projection of variable size positioned anterior to the pectoralis major and serratus anterior muscles. A fascia layer composed of dense, irregular connective tissue connects it to these muscles.
Each breast features a pigmented projection known as the nipple, through which milk emerges via closely spaced openings of ducts, referred to as lactiferous ducts. Surrounding the nipple is a circular pigmented area of skin named the areola, which appears rough due to...
876

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Updated: Aug 12, 2025

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
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Pregnancy-Associated Breast Changes after Nipple-Sparing Mastectomy.

Seth Z Aschen1, Kristine C Paik2, Alexander S Swistel3

  • 1From the Divisions of Plastic and Reconstructive Surgery.

Plastic and Reconstructive Surgery
|February 2, 2023
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Summary

Pregnancy after nipple-sparing mastectomy (NSM) can cause clinical breast changes, but these are usually benign. Ultrasound is recommended for evaluating these changes, with lactational hyperplasia being a common diagnosis.

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Area of Science:

  • Oncology
  • Reproductive Medicine
  • Plastic Surgery

Background:

  • Breast cancer significantly impacts women of reproductive age, many of whom desire future fertility.
  • Nipple-sparing mastectomy (NSM) followed by implant-based reconstruction is an option for these patients.
  • Underrepresentation of reproductive-age women in breast cancer studies necessitates further investigation.

Purpose of the Study:

  • To evaluate clinical and radiologic changes in women of reproductive age following nipple-sparing mastectomy (NSM) and subsequent pregnancy.
  • To compare pregnant patients with non-pregnant patients post-NSM.

Main Methods:

  • Prospective evaluation of patients aged 45 or younger undergoing NSM.
  • Recording of breast examination changes in patients who became pregnant after NSM.
  • Utilizing ultrasound for palpable changes and correlating findings with histopathology.

Main Results:

  • 36 patients became pregnant post-NSM; 158 did not.
  • Nearly 50% of pregnant patients reported clinical changes around delivery (e.g., nipple-areola discoloration, discharge, palpable nodularity).
  • Ultrasound revealed hypoechoic lesions; excision confirmed lactational hyperplasia as the most frequent diagnosis.

Conclusions:

  • Pregnancy after NSM frequently leads to clinical breast changes.
  • Ultrasound is a suitable initial diagnostic tool for these post-NSM breast changes.
  • The majority of pregnancy-associated breast changes after NSM are benign, often representing lactational hyperplasia.