Julie Margenthaler, MD
The moderator of the press briefing, Julie Margenthaler, MD, of Washington University, St. Louis, maintained there are few contraindications for nipple-sparing mastectomy. “I reiterate Dr. Jakub’s view. I agree it’s absolutely safe for BRCA-positive patients,” she declared.
The contraindications, she added, are cancer involving or coming within 2 cm of the nipple and breasts that are too large to support the blood supply to the nipple or to achieve an appropriate cosmetic outcome. “Outside of these two contraindications, we offer this [nipple-sparing mastectomy] to all patients, whether for prophylaxis (in women with breast cancer–related mutations) or those with active cancer,” Dr. Margenthaler revealed. ■
Disclosure: Dr. Margenthaler reported no potential conflicts of interest.
In more than 500 risk-reducing nipple-sparing mastectomies in 348 deleterious BRCA-mutation carriers, we identified no cases of primary breast cancer on the side of the prophylactic procedure.— James Jakub, MD
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