title: Nipple-areola complex sparing mastectomy with periareolar pexy for breast cancer patients with moderately ptotic breasts.
abstract: BACKGROUND
  Nipple-areola complex sparing mastectomy (NSM) with immediate implant reconstruction has been recently introduced for breast cancer patients who are not candidates for breast preserving surgery. As the cosmetic results in moderately ptotic breasts may not be optimal, a modified NSM with a periareolar pexy (PP-NSM) was introduced at our Institution. Patients selection criteria and complication rates of PP-NSM were prospectively recorded and compared with those of the classical NSM.
  
  
  RESULTS
  Over a period of 11 months, 22 PP-NSMs and 35 NSMs were performed. The mean jugular-nipple distance was significantly longer in the PP-NSM as compared with the NSM (22.6 vs. 19.6 cm; p=0.000), whereas the mean inframammary fold-areola distance was superimposable (5.4 cm). The periareolar mastopexy led to a mean cranial transposition of the nipple-areola complex (NAC) of 2.2 cm (range 1.5-4 cm). Mean breast weight was significantly higher in the PP-NSM as compared with the NSM cohort (336 vs. 236 g; p=0.003). The only case of total NAC necrosis occurred in the PP-NSM group. Partial NAC necrosis was slightly more frequent in the PP-NSM than in the NSM group (13.6% vs. 2.9%%; p=n.s.), possibly due to the higher percentage of smokers (41.0% vs. 14.0%; p=0.05). Early cosmetic results were good to excellent from the surgeon's and the patient's point of view in over 80% of the cases.
  
  
  CONCLUSIONS
  PP-NSM allows good cosmetic results and low complication rates in patients with moderately ptotic breasts requiring a mastectomy. In particular, PP-NSM seems to be a good option for women at high risk for developing breast cancer and for selected patients affected by non-locally advanced breast cancer.
authors: Gynecological Oncology Unit, Institute for Cancer Research and Treatment (IRCC) of Candiolo, Fondazione del Piemonte per l'Oncologia, Turin, Italy.
authors: Alessandro
authors: A
authors: Rivolin
authors: Franziska
authors: F
authors: Kubatzki
authors: Francesco
authors: F
authors: Marocco
authors: Laura
authors: L
authors: Martincich
authors: Stefania
authors: S
authors: Renditore
authors: Furio
authors: F
authors: Maggiorotto
authors: Alessandra
authors: A
authors: Magistris
authors: Riccardo
authors: R
authors: Ponzone
mesh_terms: D018427:Breast Implants; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy / Q000379:methods*; D009558:Nipples / Q000601:surgery*; D018579:Patient Selection; D012189:Retrospective Studies; D016896:Treatment Outcome