Nipple-sparing and skin-sparing mastectomy: Review of aims, oncological safety and contraindications

摘要: Skin-sparing (SSM) and nipple-sparing (NSM) mastectomies are relatively new conservative surgical approaches to breast cancer. In SSM most of the skin is conserved create a pocket that facilitates immediate reconstruction with implant or autologous graft achieve quality cosmetic outcome. NSM closely similar except nipple-areola complex (NAC) also conserved. Meta-analyses indicate outcomes for do not differ from those non-conservative mastectomies. Recurrence rates in NAC after acceptably low (0-3.7%). Other studies associated high patient satisfaction good psychological adjustment. Indications carcinoma DCIS require mastectomy (including neoadjuvant chemotherapy). suitable women undergoing risk-reducing bilateral mastectomy. Tumor less than 2 cm recommended, but may be important no evidence nipple involvement on mandatory intraoperative margin assessment. A positive an absolute contraindication preservation. contraindications microcalcifications close subareolar region discharge. Complication other types post-mastectomy reconstructions. The main complication necrosis, however as surgeon experience matures, frequency declines. Factors complications voluminous breast, ptosis, smoking, obesity, radiotherapy. Since access incision small, tissue left behind, so only experienced surgeons should these operations collaboration plastic surgeon. For cancer patients requiring mastectomy, option choice.