Immediate nipple-areola-sparing mastectomy reconstruction: An update on oncological and reconstruction techniques

Core Tip

Core tip: In selected patients, nipple-sparing mastectomy (NSM) has allowed an adequate oncologic control with satisfactory aesthetic outcome. In addition, utilizing the native breast skin optimizes the aesthetic outcome of the reconstructed breast and minimizes post-mastectomy deformity. The satisfactory results are due to a close collaboration with the oncological surgical team in terms of incision selection and mastectomy flap dissection. In general, choice of reconstructive procedure requires careful consideration of various patient related factors, including: breast volume, degree of ptosis, areolar size, patient preference and expectation, and surgeon experience. With careful patient selection and well-planned surgical technique, NSM can provide satisfactory outcomes with acceptable complication rates. However, available data demonstrate that NSM can be safely performed for breast cancer treatment in selected cases. Although NSM reduces the psychological trauma associated with nipple-areola complex resection, the oncologic safety as well as functional and aesthetic outcomes needs additional investigation. Thus, additional clinical studies and longer follow-up are necessary to define consistent selection criteria for NSM.