What is a Nipple-Sparing Mastectomy?

One of the most daunting parts of a debilitating illness is the notion that your quality of life will never be the same. While many women are certainly grateful to survive illnesses associated with tumor, there is often a stigma associated with deep breast-tissue removal. Fortunately, there are now patient-centered methods of mastectomy that can lead to less traumatic and more attractive results for everyone involved. A look at the process of nipple-sparing mastectomies can help women understand the options now available for women undergoing this procedure.

What is a Nipple-Sparing Mastectomy?

Nipple-sparing mastectomy is a procedure in which a surgeon removes infected breast tissue without removing the nipple or skin of the areola (also known as the nipple-areola complex). In a conventional mastectomy, a surgeon would remove the entire breast, including the nipple-areola complex and surrounding skin.

While physicians have performed mastectomies for centuries, traditional beliefs held that surgeons could not preserve breast tissue without risking tumor recurrence. Moreover, limitations in medical science often lead to extensive time gaps between breast removal and breast reconstruction.

Beginning in the 1970s, however, technological advances lead to improved preservation of tissue and increased possibility of immediate breast reconstruction. For example, the National Institutes of Health report that the likelihood of immediate breast reconstruction has increased from 10-percent of patients in the 1980s to nearly 90-percent of cases in the present-day. Moreover, surgical facilities can go over options with patients to help if the appearance and sensation within the breast can remain relatively intact.

Benefits of Nipple-Sparing Mastectomies

Some of the most distinctive benefits of nipple-sparing mastectomies include improved cosmetic appearance and body image. For many patients, the breast appears relatively unchanged. Other than a small surgical scar beneath the crease of the breast (known as the infra-mammary fold) or near the armpit, the appearance of the breast area can remain relatively the same. This unchanged appearance can have a tremendous impact on patients by lessening the physical and emotional trauma from related medical conditions. In some cases, the procedure is also much less invasive, leading to reduced recovery times as well.

Nipple-sparing mastectomies can also help preserve sensation and erectile function within the nipple. According to the Mayo Clinic, up to 60-percent of women report sensation in the nipple following surgery (compared to the impossibility of sensation in a replacement nipple constructed during plastic surgery). Research published in PubMed has also found that likelihood of breast cancer recurrence at the nipple is extremely low due to complete removal of fatty tissue in the area. The procedure allows physicians to leave the nipple skin behind for normal appearance and breast function while removing at-risk tissue from the breast core.

Who is a Good Candidate for a Nipple-Sparing Mastectomy?

Women with smaller tumors or peripherally located tumors are usually good candidates for the procedure. Generally, a surgical team (including pathologists and oncologists) can evaluate the breast area to determine the likelihood of success for the procedure. For example, women with a history of smoking, diabetes, or previous radiation treatment may not qualify for the procedure. Most physicians make final determinations on a case-by-case basis.