Many surgeons are developing the skill, but it’s technically more challenging. You need a very small incision and have limited visibility.
—Julie A. Margenthaler, MD
Julie A. Margenthaler, MD, of Siteman Cancer Center, St. Louis, who moderated a press briefing at the American Society of Breast Surgeons 16th Annual Meeting, commented on these findings and fielded some questions about the procedure.
Dr. Margenthaler indicated that although nipple-sparing mastectomy is gaining ground, it probably constitutes only about 5% of mastectomies nationwide. Among surgeons specifically trained to do it, nipple-sparing mastectomy represents at least 20% of mastectomies among their eligible patients, she estimated.
“Many surgeons are developing the skill, but it’s technically more challenging. You need a very small incision and have limited visibility,” explained Dr. Margenthaler.
She indicated the procedure might cost no more than standard skin-sparing mastectomy with reconstruction, since implants can be placed during the nipple-sparing mastectomy, making it a one-stage operation. Women with the tumor location no closer than 2 cm from the nipple are eligible for the procedure. Women with large breasts are often not the best candidates, as cosmesis tends to be worse in these patients. Preserving the nipple usually does not preserve its sensation, she added. ■
Disclosure: Dr. Margenthaler reported no potential conflicts of interest.
Mastectomies that preserve the nipple and an envelope of breast skin are as safe as more radical operations for qualifying early-stage breast cancer patients, according to a meta-analysis and systematic literature review presented at the American Society of Breast Surgeons 16th Annual Meeting.1