title: Nipple-sparing mastectomy using a hemi-periareolar incision with or without minimal medial-lateral extensions; clinical outcome and patient satisfaction: A single centre prospective observational study.
abstract: BACKGROUND
  Nipple-sparing mastectomy (NSM) is becoming a viable oncoplastic option. There is debate regarding the best approach that balances oncological safety with aesthetics. In this study, we describe an approach involving a hemi-periareolar incision and evaluate its safety and outcomes.
  
  
  METHODS
  Patients treated at single center between 2012 and 2015 were observed prospectively. After a histologically negative subareolar biopsy, immediate reconstruction with implant and acellular dermal matrix was performed after NSM. Primary end points were wound complications and explantation. Secondary end points included local recurrence, quality of life, patient satisfaction, and esthetic outcome.
  
  
  RESULTS
  Sixty-three patients were included with 92 procedures. Twenty-seven percent received chemotherapy and 12.7% received radiotherapy. Mean follow-up was 27.6 months. There were only 2 wound complications, and no recurrences. Mean outcome scores were promising (Breast Q = 88%, subjective esthetic = 9.2, objective esthetic = 9.3, hardening = 2.6).
  
  
  CONCLUSIONS
  NSM via a hemi-periareolar incision is oncologically safe with a low-complication rate and high patients' satisfaction.
authors: The London Breast Institute, Princess Grace Hospital, London, UK.
authors: Hiba
authors: H
authors: El Hage Chehade
authors: The London Breast Institute, Princess Grace Hospital, London, UK.
authors: Hannah
authors: H
authors: Headon
authors: The London Breast Institute, Princess Grace Hospital, London, UK.
authors: Umar
authors: U
authors: Wazir
authors: The London Breast Institute, Princess Grace Hospital, London, UK.
authors: Amtul R
authors: AR
authors: Carmaichael
authors: The London Breast Institute, Princess Grace Hospital, London, UK.
authors: Christina
authors: C
authors: Choy
authors: The London Breast Institute, Princess Grace Hospital, London, UK.
authors: Abdul
authors: A
authors: Kasem
authors: The London Breast Institute, Princess Grace Hospital, London, UK. Electronic address: kefahmokbel@hotmail.com.
authors: Kefah
authors: K
authors: Mokbel
mesh_terms: D062088:Acellular Dermis; D001943:Breast Neoplasms / Q000601:surgery*; D004954:Esthetics; D005260:Female; D006801:Humans; D016462:Mammaplasty; D015414:Mastectomy, Subcutaneous / Q000379:methods*; D008875:Middle Aged; D009558:Nipples; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Breast cancer; Immediate breast reconstruction; Nipple-sparing mastectomy; Periareolar incision