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World J Clin Oncol. Aug 10, 2014; 5(3): 478-494
Published online Aug 10, 2014. doi: 10.5306/wjco.v5.i3.478
Immediate nipple-areola-sparing mastectomy reconstruction: An update on oncological and reconstruction techniques
Alexandre Mendonça Munhoz, Eduardo Montag, José Roberto Filassi, Rolf Gemperli
Alexandre Mendonça Munhoz, Division of Plastic Surgery, Hospital Sírio-Libanês, São Paulo, SP 01239-040, Brazil
Eduardo Montag, José Roberto Filassi, Cancer Institute of São Paulo, University of São Paulo School of Medicine, São Paulo, SP01246-903, Brazil
Rolf Gemperli, Plastic Surgery Division, University of São Paulo School of Medicine, São Paulo, SP 01246-903, Brazil
Author contributions: Munhoz AM and Montag E collected and analyzed the data; Munhoz AM interpreted the data and wrote the paper; Filassi JR and Gemperli R analyzed and interpreted the data.
Correspondence to: Alexandre Mendonça Munhoz, MD, Division of Plastic Surgery, Hospital Sírio-Libanês, Rua Mato Grosso, 306 cj.1705-1706, Sao Paulo, SP 01239-040, Brazil. munhozalex@uol.com.br
Telephone: +55-11-96098850 Fax: +55-11-32551769
Received: December 18, 2013
Revised: January 24, 2014
Accepted: May 15, 2014
Published online: August 10, 2014
Processing time: 225 Days and 15.8 Hours
Core Tip

Core tip: In selected patients, nipple-sparing mastectomy (NSM) has allowed an adequate oncologic control with satisfactory aesthetic outcome. In addition, utilizing the native breast skin optimizes the aesthetic outcome of the reconstructed breast and minimizes post-mastectomy deformity. The satisfactory results are due to a close collaboration with the oncological surgical team in terms of incision selection and mastectomy flap dissection. In general, choice of reconstructive procedure requires careful consideration of various patient related factors, including: breast volume, degree of ptosis, areolar size, patient preference and expectation, and surgeon experience. With careful patient selection and well-planned surgical technique, NSM can provide satisfactory outcomes with acceptable complication rates. However, available data demonstrate that NSM can be safely performed for breast cancer treatment in selected cases. Although NSM reduces the psychological trauma associated with nipple-areola complex resection, the oncologic safety as well as functional and aesthetic outcomes needs additional investigation. Thus, additional clinical studies and longer follow-up are necessary to define consistent selection criteria for NSM.