Dr. Wasif provides valuable information for women considering a nipple-sparing mastectomy.
What are the advantages of a nipple-sparing mastectomy? Well the obvious one is the cosmetic advantage. You are keeping your own nipple. It cosmetically looks much nicer after reconstruction.
The cons – since this is a relatively new procedure, we have about five years follow-up data and we haven’t seen a lot of recurrences because keeping the nipple means there’s always going to be a little sliver of your own breast tissue there, but in our experience so far we have found that at least up to five years after having this operation you don’t have a recurrence in that area, and this goes back to why we started doing nipple-sparing mastectomies in the first place. It’s because over the years we have noticed that in women who do have a recurrence for breast cancer, it’s almost never at the nipple.
So that got us thinking, “Well if it’s never at the nipple why don’t we just keep the nipple? Why do we have to take it?” And again I must caution, we don’t have the long-term data, but the short-term five-year data suggests that it’s actually quite safe to leave the nipple even if it does have a little bit of breast tissue.
So that’s one thing to keep in mind. If you are not comfortable having a long-term follow-up without any data then it might not be the best way to go.
Other things that you have to also keep in mind is that even though you keep the nipple it has no function. So you kind of lose sensation around the nipple, so tactile sensation is going to be gone, as well as the erectile function of the nipple because we basically core it out and it’s just the skin and the nipple that’s left and the primary purpose for doing this is cosmetic, not functional. You will not have any function in nipple, but you will have the nipple and cosmetically I think it’s the best result you can get after a mastectomy.
About Dr. Nabil Wasif, M.D.:
Dr. Nabil Wasif, M.D., is a general surgeon at Mayo Clinic in Arizona, certified by the American Board of Surgery. He graduated from Aga Khan University Medical College in Pakistan and completed his residency in general surgeon at New York Presbyterian Hospital-Cornell in New York. His interests include surgical oncology, general surgery, GI oncology, breast cancer, melanoma, and sarcomas.