title: Oncological safety of prophylactic breast surgery: skin-sparing and nipple-sparing versus total mastectomy.
abstract: Women with a BRCA1/2 gene mutation and others with a high breast cancer risk may opt for bilateral prophylactic mastectomy. To allow for immediate breast reconstruction the skin envelope is left in situ with or without the nipple-areola complex (NAC). Although possibly leading to a more natural aesthetic outcome than the conventional total mastectomy, so-called skin-sparing mastectomies (SSM) and nipple-sparing mastectomies (NSM) may leave some breast glandular tissue in situ. The oncological risk associated with remaining breast glandular tissue is unclear. We present a case of primary breast cancer after prophylactic mastectomy followed by a review of the literature on remaining breast glandular tissue after various mastectomy techniques and oncological safety of prophylactic mastectomies.
authors.affiliation: 1 Erasmus MC Cancer Institute, Department of Surgical Oncology, Rotterdam, the Netherlands ; 2 VUmc, Department of Plastic and Reconstructive Surgery, Amsterdam, the Netherlands ; 3 Erasmus MC Cancer Institute, Department of Pathology, Rotterdam, the Netherlands.
authors.forename: Victorien M T
authors.initials: VM
authors.lastname: van Verschuer
authors.affiliation: 1 Erasmus MC Cancer Institute, Department of Surgical Oncology, Rotterdam, the Netherlands ; 2 VUmc, Department of Plastic and Reconstructive Surgery, Amsterdam, the Netherlands ; 3 Erasmus MC Cancer Institute, Department of Pathology, Rotterdam, the Netherlands.
authors.forename: Marike C
authors.initials: MC
authors.lastname: Maijers
authors.affiliation: 1 Erasmus MC Cancer Institute, Department of Surgical Oncology, Rotterdam, the Netherlands ; 2 VUmc, Department of Plastic and Reconstructive Surgery, Amsterdam, the Netherlands ; 3 Erasmus MC Cancer Institute, Department of Pathology, Rotterdam, the Netherlands.
authors.forename: Carolien H M
authors.initials: CH
authors.lastname: van Deurzen
authors.affiliation: 1 Erasmus MC Cancer Institute, Department of Surgical Oncology, Rotterdam, the Netherlands ; 2 VUmc, Department of Plastic and Reconstructive Surgery, Amsterdam, the Netherlands ; 3 Erasmus MC Cancer Institute, Department of Pathology, Rotterdam, the Netherlands.
authors.forename: Linetta B
authors.initials: LB
authors.lastname: Koppert
keywords: Risk-reduction; breast glandular tissue; nipple-sparing mastectomy (NSM); primary breast cancer; skin-sparing mastectomy (SSM); terminal duct lobular units; total mastectomy