What is a nipple-sparing mastectomy?

Dr. Stephanie Byrum is a surgeon specializing in breast disease and women’s health at Banner MD Anderson Cancer Center.

Question: What is a nipple-sparing mastectomy?

Answer: A nipple-sparing mastectomy is a relatively new surgical approach to treating breast cancer that is gaining popularity. Studies have shown that this type of surgery may lead to better cosmetic outcomes for women who choose breast reconstruction after removal of their cancerous breast, or those at risk for developing breast cancer who choose a preventive mastectomy.

In a nipple-sparing mastectomy, the surgeon removes the breast tissue, including the ducts behind the nipple, but retains the nipple and areola. The nipple and areola are then maintained as part of an immediate breast reconstruction, which is performed right after the mastectomy in the same surgical suite. This option is only available if the nipple and related tissue are cancer-free.

Recent research indicates that nipple-sparing mastectomies have relatively low complication rates and women are more satisfied with their overall breast reconstruction results. However, several factors can increase the risk of complications for women choosing this or any reconstruction option, including tobacco use because nicotine can restrict blood flow and affect healing, and radiation treatment, which also slows healing and may lead to more scarring. The location of the surgical incision can add to the complication risk, with incisions under the breast fold offering better results than those around the nipple.

The nipple-sparing approach is fast becoming a preferred option for women who are candidates for immediate breast reconstruction because of its effectiveness in removing cancerous tissue while preserving the nipple and areola to improve the appearance and feel of the reconstructed breast. However, since every woman is unique and so is her breast cancer, it is important to explore this and all available surgical procedures with the patient’s surgical team.