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2015 ; 4
(6
): 528-40
Nephropedia Template TP
Rossi C
; Mingozzi M
; Curcio A
; Buggi F
; Folli S
Gland Surg
2015[Dec]; 4
(6
): 528-40
PMID26645007
show ga
Breast conservative therapy (BCT) is established as a safe option for most women
with early breast cancer (BC). The best conservative mastectomy that can be
performed, when mastectomy is unavoidable, is nipple-areola-complex sparing
mastectomy (NSM), which allows the complete glandular dissection preserving the
skin envelope and the nipple areola complex. In the treatment of BC, the cosmetic
outcomes have become fundamental goals, as well as oncologic control. NSM is
nowadays considered an alternative technique to improve the overall quality of
life for women allowing excellent cosmetic results because it provides a natural
appearing breast. The breast surgeon must pay attention to details and skin
incision must be planned to minimize vascular impairment to the skin and the
nipple. Preservation of the blood supply to the nipple is one of the most
important concern during NSM because nipple or areolar necrosis is a
well-described complication of this surgery. Another issue associated with the
nipple preservation and the surgical technique is oncological safety related to
nipple-areola-complex (NAC) involvement in patients with invasive BC. The authors
present their experience on 252 NSM performed in the Breast Surgery Unit in
Forlì. Careful selection of patients for this surgical procedure is imperative
and many patients are not ideal candidates for this procedure because of concerns
about nipple-areolar viability as women with significant large/ptotic breast,
pre-existing breast scars and history of active cigarette smoking. To extend the
benefits of nipple preservation to patients who are perceived to be at higher
risk for nipple necrosis the authors describe technical modifications of NSM to
allow nipple preservation and obtain good cosmetic outcomes.
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