title: Circum-areolar mastectomy with immediate reconstruction (CAMIR).
abstract: OBJECTIVE
  To develop an oncologically safe and aesthetically acceptable technique for mastectomy using a myocutaneous flap and tissue expander for patients with neoplastic involvement of the nipple.
  
  
  METHODS
  Fourteen consecutive patients (mean age 40 years) underwent a circum-areolar mastectomy with immediate reconstruction using a latissimus dorsi myocutaneous flap and tissue expander. Assessment of cosmesis was by review of pre- and post-operative photographs by an independent observer.
  
  
  RESULTS
  During a mean follow-up of 11.4 months there have been no local recurrences. There were two deaths: pulmonary embolus (one) and distant metastatic disease (one). Assessment of cosmesis gave a score of 47 out of 56 (84%).
  
  
  CONCLUSIONS
  In patients with tumours involving the nipple, mastectomy with immediate reconstruction may be used to achieve a good cosmetic result. The replacement nipple is fashioned from a circle of skin attached to the latissimus dorsi myocutaneous harvest.
authors.affiliation: The Breast Unit, Basildon and Thurrock NHS Trust, Basildon Hospital, Nethermayne, UK.
authors.forename: P A
authors.initials: PA
authors.lastname: Sufi
authors.forename: M
authors.initials: M
authors.lastname: Gittos
authors.forename: D S
authors.initials: DS
authors.lastname: Collier
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D002277:Carcinoma / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D009558:Nipples / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome