Nipple-sparing mastectomy: A contemporary perspective

Sisco, Mark; Yao, Katharine

doi:10.1002/jso.24209

Cited by 31 publications

(25 citation statements)

References 104 publications

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“…Complication rates computed in this review do not seem to vary considerably from complication rates reported in reviews on NSM in general. 1 , 7 , 9 , 33 …”

Section: Discussionmentioning

confidence: 99%

“…Complication rates related to NSM appear to be comparable with those of skin-sparing mastectomy (SSM) and the ability to preserve the nipple areola complex (NAC) has led to a high level of patient satisfaction. 1 , 2 Since the introduction of acellular dermal matrix (ADM) in breast reconstruction in 2001 3 , 4 the combination of NSM and immediate breast reconstruction (IBR) with ADM and submuscular placement of the implant has increased significantly for both therapeutic and risk reducing mastectomies. 5 ADM is a durable, nonimmunogenic, and elastic material derived from human or porcine skin tissue and serves as a reinforcement in the reconstruction.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Complications following Nipple-Sparing Mastectomy and Immediate Acellular Dermal Matrix Implant-based Breast Reconstruction—A Systematic Review and Meta-analysis

Heidemann

Gunnarsson

Salzberg

et al. 2018

Plastic and Reconstructive Surgery - Global Open

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“…Complication rates computed in this review do not seem to vary considerably from complication rates reported in reviews on NSM in general. 1 , 7 , 9 , 33 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Complications following Nipple-Sparing Mastectomy and Immediate Acellular Dermal Matrix Implant-based Breast Reconstruction—A Systematic Review and Meta-analysis

Heidemann

Gunnarsson

Salzberg

et al. 2018

Plastic and Reconstructive Surgery - Global Open

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“…It was initially thought that sparing the NAC would often preserve sensitivity. For example, a 2016 review by Sisco et al [10] reported that sensory outcomes in NSM varied, with normal sensation self-reported in the range 10-43%. However, it has now become clear and that nipple sensation is largely or completely lost in most cases.…”

Section: Introductionmentioning

confidence: 99%

Nipple-sparing and skin-sparing mastectomy: Review of aims, oncological safety and contraindications

et al. 2017

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Skin-sparing (SSM) and nipple-sparing (NSM) mastectomies relatively new conservative surgical approaches to breast cancer. In SSM most of the breast skin is conserved to create a pocket that facilitates immediate breast reconstruction with implant or autologous graft to achieve a quality cosmetic outcome. NSM is closely similar except that the nipple-areola complex (NAC) is also conserved. Meta-analyses indicate that outcomes for SSM and NSM do not differ from those for non-conservative mastectomies. Recurrence rates in the NAC after NSM are acceptably low (0-3.7%). Other studies indicate that NSM is associated with high patient satisfaction and good psychological adjustment. Indications are carcinoma or DCIS that require mastectomy (including after neoadjuvant chemotherapy). NSM is also suitable for women undergoing risk-reducing bilateral mastectomy. Tumor not less than 2cm from the NAC is recommended, but may be less important than no evidence of nipple involvement on mandatory intraoperative nipple margin assessment. A positive margin is an absolute contraindication for nipple preservation. Other contraindications are microcalcifications close to the subareolar region and a positive nipple discharge. Complication rates are similar to those for other types of post-mastectomy reconstructions. The main complication of NSM is NAC necrosis, however as surgeon experience matures, frequency declines. Factors associated with complications are voluminous breast, ptosis, smoking, obesity, and radiotherapy. Since the access incision is small, breast tissue may be left behind, so only experienced breast surgeons should do these operations; close collaboration with the plastic surgeon. For breast cancer patients requiring mastectomy, NSM should be the option of choice.

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“…In addition to limiting the surgical exposure and being at higher risk for flap necrosis [13], they may also result in less favorable cosmetic results because of the larger skin envelope which may need to be tailored for the reconstruction. As a solution to this problem, various mastopexy-type incisions can be used in these patients [13].…”

Section: Ptosismentioning

confidence: 99%

“…Though the overall necrosis rates with this incision are approximately 9%, the risk of NAC necrosis is decreased if thicker flaps that leave most of the subcutaneous breast fat intact are used [11,27]. Additionally, access to the internal mammary or thoracodorsal pedicles can be challenging through this incision [13].…”

Section: Inframammary Fold Incisionmentioning

confidence: 99%

Microsurgical Flaps in Nipple Sparing Mastectomy: Surgical Techniques and Aesthetic Principles

Azadgoli¹,

Gould²,

Patel³

2018

IMJ

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Nipple-sparing mastectomy: A contemporary perspective

Cited by 31 publications

References 104 publications

Complications following Nipple-Sparing Mastectomy and Immediate Acellular Dermal Matrix Implant-based Breast Reconstruction—A Systematic Review and Meta-analysis

Complications following Nipple-Sparing Mastectomy and Immediate Acellular Dermal Matrix Implant-based Breast Reconstruction—A Systematic Review and Meta-analysis

Nipple-sparing and skin-sparing mastectomy: Review of aims, oncological safety and contraindications

Microsurgical Flaps in Nipple Sparing Mastectomy: Surgical Techniques and Aesthetic Principles

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