Ann Surg Treat Res.  2020 Feb;98(2):57-61. 10.4174/astr.2020.98.2.57.

Nipple-sparing mastectomy through periareolar incision with immediate reconstruction

• Paek SH
• Hong SE
• Woo KJ
• Woo J
• Lim W

• KMID: 2469104
• DOI: http://doi.org/10.4174/astr.2020.98.2.57

Abstract

PURPOSE
Nipple-sparing mastectomy (NSM) has become increasingly popular due to improved cosmesis without compromising oncologic safety. Radial and inframammary incisions are usually used to achieve NSM, with periareolar incisions usually being avoided because of the risk to nipple-areola complex viability. In an attempt to maximize esthetic effects, we performed NSM through periareolar incision with immediate reconstruction. We report our initial experience.
METHODS
This case series consisted of all consecutive patients (n = 34) who underwent NSM through a periareolar incision in our institution between August 2017 and December 2018. All patients underwent NSM through periareolar incision followed by immediate reconstruction with an implant or deep inferior epigastric perforator flap. Patient demographics, tumor and treatment characteristics, and short-term postoperative outcomes were reviewed.
RESULTS
The mean patient age was 46.74 ± 6.69 years (range, 38-62 years), and the mean operation time was 96.68 ± 28.00 minutes. Indications included in situ cancer in 12 cases and invasive cancer in 22 cases. There was 1 major complication (postoperative hematoma) requiring operative reintervention. No other complications including fistula, implant exposure, or reconstruction failure was observed. At the time of writing, no case of local recurrence has been observed.
CONCLUSION
Our initial report shows that NSM with immediate reconstruction may successfully be performed through periareolar incision. This method maximizes esthetic effects and may be an appropriate surgical option for NSM.

Keyword

Mammaplasty; Periareolar; Subcutaneous mastectomy

MeSH Terms

Demography
Female
Fistula
Humans
Mammaplasty
Mastectomy*
Mastectomy, Subcutaneous
Methods
Perforator Flap
Recurrence
Writing

Figure

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  Fig. 1 Nipple-sparing mastectomy incision. The round line indicates the breast parenchyme to be resected and the red semicircular line shows the place to make incision.

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  Fig. 2 Intraoperative and late postoperative view. Periareolar incisions produced well-hidden incision scars within the periphery of the nipple-areola complex. (A) A 51-year-old female with invasive ductal carcinoma of right breast. We performed right nipple-sparing mastectomy with periareolar approach. Resected mastectomy volume was 293 g. (B) A 47-year-old female with intraductal carcinoma in situ of left breast. We performed left nipple-sparing mastectomy with periareolar approach. Resected mastectomy volume was 334 g.

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