Nipple-sparing mastectomy with implant reconstruction: the Westmead experience.
BACKGROUND
Nipple-sparing mastectomy (NSM) involves the removal of all breast tissue with preservation of the breast skin envelope and nipple-areola complex (NAC). The objective of this study was to report the outcomes from our initial experience with NSM.


METHODS
We retrospectively analysed 87 women who underwent 118 NSMs between October 2008 and May 2012.


RESULTS
Indications for NSM were 60 (51%) primary cancer, 15 (13%) residual/recurrent disease, 39 (33%) risk reduction and 4 (3%) benign pathology. Implant loss (n = 10) was associated with subcutaneous placement (P = 0.01), post-operative seroma and infection (P = 0.028, 0.001), skin flap necrosis (P = 0.007) and NAC loss (P = 0.027). Capsular contraction was related to adjuvant radiotherapy (P = 0.044). Local recurrence occurred in four patients, and NAC recurrence with invasive cancer occurred in one patient after a median follow-up of 30 months.


CONCLUSIONS
Our Australian NSM series adds to the published literature supporting the oncological safety of NSM for early-stage breast cancer and risk reduction.
Westmead Hospital, Westmead Breast Cancer Institute, Westmead, New South Wales, Australia.
Samriti
S
Sood
Elisabeth
E
Elder
James
J
French
D000293:Adolescent; D000328:Adult; D000368:Aged; D019928:Breast Implantation; D001943:Breast Neoplasms / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000601:surgery*; D018275:Carcinoma, Lobular / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015414:Mastectomy, Subcutaneous; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
breast cancer; breast reconstruction; nipple-areola complex; nipple-sparing mastectomy; risk reduction