Nipple-Sparing Mastectomy Safe for Selected Patients

Subareolar biopsy useful in identifying cancerous nipple-areolar complexes

FRIDAY, Oct. 28 (HealthDay News) -- Nipple-sparing mastectomy (NSM) can be safe when used for properly-selected women with breast cancer, according to a study published in the November issue of Plastic and Reconstructive Surgery.

Scott L. Spear, M.D., from Georgetown University Hospital in Washington, D.C., and colleagues assessed the safety and effectiveness of therapeutic and prophylactic NSM in 101 women who underwent 162 NSMs from 1989 to 2010 at a single institution. Of these mastectomies, 30 and 70 percent were performed for therapeutic and prophylactic reasons, respectively. Participants in the therapeutic group were followed up for an average of two years and six months, and those in the prophylactic group for an average of three years and seven months. Subareolar biopsies were performed in 80 and 71 percent of breasts in the therapeutic and prophylactic groups, respectively.

The investigators found that 10 percent of the subareolar biopsies in the therapeutic group revealed ductal carcinoma in situ (DCIS), and the nipple or nipple-areolar complexes (NACs) were excised. Eight percent of breasts in the therapeutic group developed ischemic complications involving the NAC, of which 2 percent were removed. No cancer was detected in the NAC during the follow-up period. In the prophylactic group, one biopsy specimen had lobular carcinoma in situ, but no DCIS or invasive cancer was reported. From the prophylactic group, 1.8 percent of breasts developed NAC ischemia, and were removed. No new primary cancers were detected in the NAC during the follow-up.

"Nipple-sparing mastectomy can be safe in properly-selected patients," the authors write.

Two authors disclosed financial ties to Lifecell and Allergan Corporations.

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Updated on June 05, 2022

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