How We Can Help

• Car Accidents
• Nursing Home Injury
• Medical Malpractice
• Child Injuries

Nipple-Sparing Mastectomy Does Not Increase Risk for Return of Breast Cancer

More than 20 years of research shows there is no significant risk of breast cancer after nipple-sparing mastectomy for the treatment or prevention of breast cancer.

Dr. Scott L. Spear and colleagues at Georgetown University Hospital analyzed data from their hospital's experience with the nipple-sparing mastectomy, a modified mastectomy technique, from 1989 to 2010. During this time period, doctors performed a total of 162 nipple-sparing mastectomies in 101 women. Thirty percent of the operations - 49 operations in 48 patients - were performed for treatment of diagnosed breast cancer.

The remaining 70 percent of the nipple-sparing mastectomies - 113 operations in 80 patients - were performed on women at high risk of breast cancer undergoing preventive mastectomy.

Women like nipple-sparing mastectomy because the nipple and surrounding tissues are preserved for use in reconstructing the breast. The breast reconstruction is generally performed immediately after mastectomy.

Nipple-sparing mastectomy has important benefits including patient satisfaction and body image, but it also means fewer operative procedures and complications. However, it is a procedure that has been slow to catch on due to perceived safety risks. One of the biggest concerns is that the preserved tissue might be a source of breast cancer cells.

To address these issues, Dr. Spear and colleagues sought to provide objective data on the risks and outcomes of nipple-sparing mastectomy. Analyzing a sample of the tissue from under the nipple before reconstructing the breast was a key part of the procedure, researchers say.

Evidence of breast cancer cells was found in only 10 percent of biopsies from the women with breast cancer and one patient undergoing preventive mastectomy. In these cases, the nipple was not used in the breast reconstruction process.

The biopsies showed no evidence of cancer for the remaining patients and the tissues were used for breast reconstruction. At an average follow-up of more than three years, there were no recurrent cancers of the nipple-areola complex in women undergoing therapeutic mastectomy, and no primary cancers in women undergoing preventive mastectomy.

This supported previous findings that the long-term risk of cancer developing in the nipple and surrounding tissues after nipple-sparing mastectomy is "zero or near-zero," Dr. Spear and colleagues write.

Another common concern about nipple-sparing mastectomy is that it will lead to problems with blood flow (ischemia) to the nipple and areola after reconstruction. Ischemia was a significant complication in two percent of cases in the study; the authors believe that steps can be taken to minimize this risk.

Researchers emphasize that nipple-sparing mastectomy isn't a good match for all women with breast cancer, like women with large breasts or more advanced cancers. However, in appropriately selected cases, researchers believe that nipple-sparing mastectomy has important advantages.

Whether the procedure is being done for treatment or prevention of breast cancer, preserving the nipple and surrounding tissues for use in reconstruction can improve the outcomes of surgery without increasing the risk of later breast cancer.

Dr. Spear and colleagues say that performing a biopsy of the underlying tissue is an important and vital part of nipple-sparing mastectomy — especially when it’s performed for breast cancer treatment.

For more on medical issues, see the library of articles by Daytona Beach medical malpractice attorney.

Your Questions Answered