Nipple Sparing Mastectomy

These are special modifications of the mastectomy procedure. This option is provided after detailed discussion and deliberation to decide your eligibility for this procedure. A cosmetically placed or even hidden incision is given to remove the entire breast fatty tissue including the cancerous lump, but the breast skin and nipple area with its blood supply will be meticulously saved. The loss of breast fat will be replaced by either body’s own tissue or an implant, leading to an appearance which is similar to pre-surgery appearance.


What to expect in surgery

The surgery is performed under complete anesthesia (GA), and a cosmetically placed/ hidden incision is given.

The entire breast fatty tissue including the cancer is removed along with some or all lymph nodes from the axilla (as per stage). The procedure takes 2-3 hours which is then followed by the reconstruction procedure. The expected stay in hospital is 5-6 nights after surgery. An ICU stay may be needed depending on type of reconstruction needed.

You will be mobile and out of bed in 1-2 days. There will be small plastic tubes (called Drains) connected to suction box to collect the any fluid. These drains are kept for 10-14 days. You will be advised some physiotherapy and exercise to recover well. You will be asked to avoid heavy exertion or exercise/lifting for some time after the procedure.

The risks / complications of the procedure include blackening of skin edges or the skin flap/ nipple, bleeding, infection, arm swelling, fluid collection at surgery site (seroma), numbness in inner aspect of arm and risks arising from general anesthesia.

Nipple Sparing Mastectomy

Advantages

  • Good cosmetic results with higher patient satisfaction
  • Allows good local control
  • Preserves breast shape even in small breast size or larger tumors
  • Permanent breast loss avoided
  • Positive Psycho-social impact on body image
  • Can avoid radiotherapy in early stages

Disadvantages

  • Technically difficult surgery
  • Can’t be done if no desire of breast reconstruction
  • Longer hospital stay
  • Can’t be done at a smaller/ less equipped center
  • Cost
  • Higher complication rates on in-experienced hands

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