Abstract
Background. Skin and nipple areola sparing mastectomy (NASM) has recently gained popularity as the management of breast cancer. This study aims to evaluate the aesthetic outcome, patient satisfaction, and oncological safety of NASM. Methods. The study prospectively analyzes the results of NASM and immediate breast reconstruction in 34 women with breast cancer. The criteria for inclusion were core biopsy-proven, peripherally located breast cancer of any tumor size and with any “N” status, with documented negative intraoperative frozen section biopsy of retroareolar tissue, and distance from the nipple to tumor margin >2 cm on mammography. Results. The median age of the patients was 45 years. The majority had either stage II or stage III breast cancer. The median mammographic distance of tumor from nipple areola complex (NAC) was 3.8 cm. The overall operative morbidity was minimal. The NAC could be preserved in all the patients. There was no local recurrence of tumor at median follow-up of 28.5 months. The aesthetic outcomes were satisfactory. Conclusion. NASM and immediate breast reconstruction can be successfully achieved with minimal morbidity and very low risk of local recurrence in appropriately selected breast cancer patients, with acceptable aesthetic results and good patient satisfaction.
Highlights
Modified radical mastectomy is a disfiguring operation that is associated with considerable psychological trauma for the affected woman
Research to find a feasible alternative has led to the renewal of interest in skin sparing and nipple areola complex sparing mastectomy (NASM) which entails the removal of the breast tissue while preserving the natural skin envelope as much as possible
There were sporadic reports of mastectomy with nipple areola complex (NAC) preservation for breast cancer treatment in the 1980s the technique fell into disuse during subsequent years due to controversies about its oncologic safety [1,2,3]
Summary
Modified radical mastectomy is a disfiguring operation that is associated with considerable psychological trauma for the affected woman. There were sporadic reports of mastectomy with NAC preservation for breast cancer treatment in the 1980s the technique fell into disuse during subsequent years due to controversies about its oncologic safety [1,2,3]. Skin and nipple areola sparing mastectomy (NASM) has recently gained popularity as the management of breast cancer. This study aims to evaluate the aesthetic outcome, patient satisfaction, and oncological safety of NASM. The study prospectively analyzes the results of NASM and immediate breast reconstruction in 34 women with breast cancer. NASM and immediate breast reconstruction can be successfully achieved with minimal morbidity and very low risk of local recurrence in appropriately selected breast cancer patients, with acceptable aesthetic results and good patient satisfaction
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