Nipple-sparing mastectomy-initial experience at a tertiary center

Background: Nipple-sparing mastectomy (NSM) combines skin-sparing mastectomy with preservation of the nipple-areolar dermis and intraoperative pathologic assessment of the nipple core. We evaluated our initial experience with NSM in terms of clinical outcomes. Methods: An Institutional Review Board-approved retrospective review of patients undergoing NSM between November 2005 and June 2007 was performed. Results: Eighteen NSM and two areola-sparing mastectomies were performed. Indications for surgery were invasive cancer (n = 4), ductal carcinoma in situ (DCIS) (n = 5), pseudoangiomatous stromal hyperplasia (n = 3), and risk reduction (n = 8). The average distance of tumor from the nipple on imaging was 4.8 cm (range 4 to 5.7). Nipple cores were all benign, and 2 patients developed self-limited superficial desquamation of the nipple. At a mean follow up of 10.8 months, all nipple-areolar complexes were intact, and there were no local or systemic recurrences. Conclusions: NSM can be successfully achieved with low morbidity in appropriately selected patients.