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For many women considering breast reconstruction, nipple-areola-sparing mastectomy may eliminate the need to reconstruct the nipple-areola complex. As the name suggests, nipple-areola-sparing mastectomy is performed in order to preserve the patient's nipple and areola and to avoid further surgery to reconstruct the nipple and areola. The decision to retain the nipple, areola, and any additional skin, is based upon an important criterion: generally, the area of cancer should be a minimum of two centimeters away from the tissue to be saved.
Nipple-areola-sparing techniques can be used in combination with most mastectomy surgeries to retain more skin than is retained in a simple or total mastectomy. The incision to remove the breast tissue is either made around the areola, thus preserving both the nipple and areola or in a remote position like the inframammary fold. The nipple-areola remains attached to the adjacent breast skin.
For cancer cell evaluation, a sample of the patient's tissue under the nipple is taken during the procedure. The entire nipple-areola complex is only removed if cancer cells are found. Despite the nipple-areola complex being preserved, it usually loses normal sensation due to resection of the nerves. Its shape can also change and flatten as a result.
Because nipple areola-sparing mastectomy is an evolving technique, a surgeon may recommend simple, total, or modified radical mastectomy instead.
A nipple areola-sparing mastectomy combined with immediate breast reconstruction may be completed in approximately three to six hours and usually requires a hospital stay of one to three days. Your personal treatment plan for mastectomy and breast reconstruction during or after mastectomy will be determined by your surgeon.
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