Nipple-sparing mastectomy--is it worth the risk?
Nipple-sparing mastectomy (NSM) is a surgical protocol designed to reduce the disabling psychological effects of radical or skin-sparing mastectomy. The preservation of the nipple-areola complex produces a more-natural result of the breast reconstruction, but this preservation is suspected of increasing tumor local recurrence. To reduce this risk, different approaches have been proposed: restrict the inclusion criteria and/or add localized radiation therapy. The local recurrence rate in recent series of patients receiving NSM is comparable with the local recurrence rate in modified radical or skin-sparing mastectomies. Today, the quality of the subcutaneous mastectomy technique allows for a more radical glandular removal, especially in the retroareolar area; therefore, local recurrence is observed in 3-6% of patients at 5 years, consistent with traditional mastectomy.
Division of Plastic Surgery, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy. jean.petit@ieo.it
Jean-Yves
JY
Petit
Umberto
U
Veronesi
Visnu
V
Lohsiriwat
PierCarlo
P
Rey
Giuseppe
G
Curigliano
Stefano
S
Martella
Cristina
C
Garusi
Francesca
F
De Lorenzi
Andrea
A
Manconi
Edoardo
E
Botteri
Florence
F
Didier
Roberto
R
Orecchia
Mario
M
Rietjens
D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008408:Mastectomy; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009558:Nipples / Q000473:pathology* / Q000601:surgery