Abstract
IntroductionNipple-sparing mastectomy (NSM), a procedure involving careful dissection of the breast tissue whilst keeping the nipple-areola complex (NAC) intact, is now increasingly practiced amongst surgeons in the treatment of certain situations of breast cancer. Given the importance of breasts to the female body image, this type of conservative breast surgery takes into account patient satisfaction and overall cosmesis, whilst ensuring appropriate oncological safety.Methods and resultsFour nipple-sparing mastectomy procedures were performed in our tertiary care centre, Princess Basma Teaching Hospital, in Jordan between June and September 2019. Indications for these procedures included invasive ductal carcinoma, malignant phyllodes, and high-grade ductal carcinoma in-situ. Patients were carefully assessed prior to surgical intervention using radiological imaging, ensuring a distance from NAC of >2 cm in all cases. Procedures were performed successfully with minimal intraoperative and no post-operative complications. Follow-up was carried out at 24 months, with no cases of local or distant post-operative recurrence, and patient satisfaction was qualitatively measured with the use of a BREAST-Q questionnaire. The questionnaire demonstrated improved overall physical well-being and satisfaction with an average overall post-operative physical well-being of 97%.ConclusionFollowing nipple-sparing mastectomy and immediate submuscular reconstruction with silicone implants,patients demonstrated high levels of satisfaction and quality of life (QoL) as measured by BREAST-Q survey. Two years of follow-up confirmed high patient satisfaction with increased scores from the preoperative baseline level.
Highlights
Nipple-sparing mastectomy (NSM), a procedure involving careful dissection of the breast tissue whilst keeping the nipple-areola complex (NAC) intact, is increasingly practiced amongst surgeons in the treatment of certain situations of breast cancer
Conservative mastectomy occurs in tandem with immediate reconstruction, which can further enhance overall patient satisfaction [3]. In hindrance to it becoming a mainstay in breast cancer treatment, conservative mastectomy has long been under scrutiny, especially so in oncological safety, as well as the risk of potential post-operative complications, most notably nipple necrosis [3]
Following approval by the Jordanian Ministry of Health Institutional Review Board (IRB), approval number Moh/REc/2021/96, a retrospective review study was carried out on four patients with varying breast pathologies whom after careful clinical assessment were found to be suitable for nipple-sparing mastectomy procedures
Summary
Nipple-sparing mastectomy (NSM), a procedure involving careful dissection of the breast tissue whilst keeping the nipple-areola complex (NAC) intact, is increasingly practiced amongst surgeons in the treatment of certain situations of breast cancer. Given the importance of breasts to the female body image, this type of conservative breast surgery takes into account patient satisfaction and overall cosmesis, whilst ensuring appropriate oncological safety
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