Women facing surgery for breast cancer may be candidates for newer techniques that improve the appearance of their breast reconstruction. Skin sparing mastectomies have been used now for several years to treat early stage breast cancer meeting certain criteria. However, nipple sparing mastectomies have met with greater concern and are not as widely performed.
The advantage of a nipple sparing mastectomy is that the nipple may retain sensation and erectile ability while nipples created with grafts, tattoos or reconstructed do not. The risk of having a nipple sparing mastectomy is uncertainty as to whether cancer may return because the nipple was saved. For women who are interested in this type of mastectomy, there are naturals concerns as to whether it is a good or bad idea to try to preserve their nipple.
A nipple-sparing mastectomy is difficult to perform because the surgeon needs to remove much of the tissue inside the breast to make sure there is no cancer left while still leaving the breast skin and nipple intact for reconstruction. Most of the nerves and blood vessels that provide sensation and erectile ability of the nipple will be removed so there is no assurance that the woman will actually regain sensation or that enough blood supply will be left to support the nipple tissue. The nipple may later need to be removed. Nipple sparing mastectomies have only been performed for the last few years so there is no tried and true best technique.
Those selected to have nipple-sparing mastectomies must first meet the criteria of skin sparing mastectomies. (See my article: Skin Sparing Mastectomy (SSM) at www.empowher.com/news/herarticle/2010/02/08/skin-sparing-mastectomy-ssm.) The tumor must be at least 2 cm (about 1inch) from the nipple, smaller than 3 cm (1and a half inches) and meet other oncology restrictions. Additionally, during the surgery a specimen from the nipple will be sent for microscopic evaluation.
If the nipple and skin area are deemed cancer free, the woman will have her breast with nipple intact reconstructed immediately after the cancer tissue is removed.