title: Temporary banking of the nipple-areola complex in 97 skin-sparing mastectomies.
abstract: BACKGROUND
  Despite the improved appearance associated with skin-sparing mastectomy, removal of the nipple-areola complex has a negative impact on the patient. Still, nipple-areola complex-sparing mastectomy results in preservation of a substantial amount of mammary tissue at risk. This may be prevented by preservation of the nipple-areola complex as a graft that is temporarily banked (e.g., in the groin region).
  
  
  METHODS
  Ninety-seven nipple-areola complexes were banked as part of preventive (n = 62) or therapeutic (n = 35) skin-sparing mastectomies in 61 women with a median age of 41 years (range, 27 to 59 years) and a minimum follow-up of 2 years. The areola was harvested as a full-thickness skin graft with the nipple attached as a composite graft. In oncologic cases, the nipple-areola complexes were banked only after frozen section clearance.
  
  
  RESULTS
  Seventy-five nipple-areola complexes were replanted onto the reconstructed mammary mound after 10 months (range, 3 to 26 months). Repeated graft take was moderate to good in 73 of these 75 nipple-areola complexes. The projection of the nipple and pigmentation of the areola were moderate to good in 45 and 74 of the 75 repeatedly transplanted grafts, respectively.
  
  
  CONCLUSIONS
  In skin-sparing mastectomy, maximum oncologically safe conservation of autologous mammary structures can be realized by means of temporary banking of the nipple-areola complex. Even though such banking may not be successful in all women, it proved to be satisfactory in most.
authors.affiliation: Amsterdam, The Netherlands From the Departments of Plastic and Reconstructive Surgery, Psychosocial Counseling, and Psychosocial Research and Epidemiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital.
authors.forename: A Kalam J
authors.initials: AKJ
authors.lastname: Ahmed
authors.forename: Daniëla E E
authors.initials: DEE
authors.lastname: Hahn
authors.forename: J Joris
authors.initials: JJ
authors.lastname: Hage
authors.forename: Eveline M A
authors.initials: EMA
authors.lastname: Bleiker
authors.forename: Leonie A E
authors.initials: LAE
authors.lastname: Woerdeman
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery; D005260:Female; D006119:Groin; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D009558:Nipples / Q000601:surgery; D012092:Replantation; D016038:Skin Transplantation / Q000379:methods; D020858:Tissue and Organ Harvesting