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Nipple-sparing mastectomy is the latest evolution in mastectomy technique. The procedure preserves the entire skin envelope and nipple areola. Only the underlying breast tissue is removed. When combined with immediate breast reconstruction, nipple-sparing mastectomy provides superior cosmetic results without compromising cancer treatment.
At PRMA, we routinely offer nipple-sparing mastectomy to appropriate candidates. The procedure can be performed in conjunction with any type of breast reconstruction.
What is Nipple-Sparing Mastectomy?
Nipple-sparing mastectomy preserves the nipple and areola and all the breast skin envelope around it. Only the breast tissue under the skin and nipple-areola is removed. A skin-sparing mastectomy also preserves the breast skin envelope but unlike the nipple-sparing procedure, removes the nipple and areola.
Who is a Candidate?
Nipple-sparing mastectomy is an option for many patients with a small cancer located several centimeters away from the nipple-areola complex. Patients with ductal carcinoma in situ (DCIS) can also be candidates depending on the location and distance from the nipple-areola. Recent studies strongly suggest that patients with cancers even closer to the nipple may also be candidates for the procedure without compromising cancer care; ultimately, this decision should only be made in consultation with your breast cancer surgeon.
Patients who need a significant breast lift for the best cosmetic results may not be ideal candidates; ultimately, this depends on the degree of lift required, the method of breast reconstruction chosen and surgeon experience.
During the surgery, the breast tissue on the underside of the areola is shaved away. In patients that have a known breast cancer, this tissue is sent as a biopsy to make sure there is no cancer under the nipple or areola. If this biopsy is negative then the nipple-areola can be preserved. If the biopsy is positive for cancer cells, the nipple and areola must be removed.
The Types of Nipple-Sparing Mastectomy Incisions (* indicates incisions typically used by PRMA surgeons)
Vertical Periareolar Extension*
Lateral Periareolar Extension*