Nipple-sparing mastectomy keeps the nipple and areola intact along with the breast skin. There are many different incisions used to do this surgery. Your breast surgeon and plastic surgeon will discuss with you which incision option is best for you given your cancer location and breast shape/size.
In all cases, all visible breast tissue is removed. Sometimes, tissue beneath the nipple and areola are checked for cancer immediately at the time of surgery. If cancer is detected, then the nipple is removed, converting the procedure to a skin-sparing mastectomy.
With either surgery, breasts are then reconstructed with a tissue expander, an implant, or tissue taken from another area of the body.
Poor candidates for nipple-sparing mastectomy include:
- Women whose tumor is close to or involving the nipple.
- Women who have been diagnosed with inflammatory breast cancer or advanced breast cancer with skin involvement.
- Women who smoke.
- Women with large or ptotic (sagging) breasts.
- Women who want smaller reconstructed breasts than their original size.