Nipple Sparing Mastectomy

A mastectomy is a surgery to remove the entire breast. It is a treatment option for women who have breast cancer or those who elect to have a prophylactic mastectomy, which is a preventive surgery that removes a normal breast to prevent the occurrence of breast cancer. With a nipple-sparing mastectomy, a woman’s existing, natural nipple and areola are preserved. The obvious advantage is the aesthetic benefit, as no further surgery is required to reconstruct the nipple-areola complex. In addition, with modern breast reconstruction surgery techniques, undergoing mastectomy does not mean having to give up a feminine or natural breast appearance.

Traditional Nipple-Sparing Mastectomy

All conventional forms of nipple-sparing mastectomy involve some type of incision on the breast itself. While the nipple and areola are preserved, incisions on the breast will allow for the removal of the underlying breast tissue. There are various options for incisions that can be utilized in traditional nipple sparing mastectomy. These include inframammary (along the fold of the breast), peri-areolar (around the nipple areola complex), or lateral (along the breast). Regardless, they all share one common element: all are located on the breast. Once the appropriate incision is selected, the surgery is performed open, directly through that incision. In addition, to being on the breast, the incision has to be large to allow for adequate exposure.

Robotic Breast Procedures

Robotic Nipple-Sparing Mastectomy with Robotic Breast Reconstruction

Robotic nipple-sparing mastectomy with robotic breast reconstruction involves using the robot to perform the surgery. The traditional (open) nipple-sparing mastectomy and breast reconstruction require long incisions that result in unsightly scars on the breast. Instead, by using the robot, the same surgery can be done with much smaller incisions that are located far away from the breasts, near the armpit or the bra line. This may result not only in a better aesthetic outcome, but fewer complications, faster recovery, and less pain.

Robotic Breast Procedures

Who is a Candidate for Robotic Breast Surgery?

Any woman who is considering nipple-sparing mastectomy, should be evaluated for robotic nipple-sparing mastectomy with robotic breast reconstruction. Robotic breast surgery is possible in breast cancer patients considering breast cancer surgery. More so, it is strongly encouraged for women, without breast cancer, but those who have a genetic mutation making them susceptible to breast cancer and are considering preventative (prophylactic) mastectomy.

BRCA and Robotic Nipple Sparing Mastectomy

Even if you do not have a cancer diagnosis, you may consider having a robotic nipple-sparing mastectomy with robotic breast reconstruction. Bilateral prophylactic (preventative double) mastectomy involves removing both breasts in order to reduce breast cancer risk. Most women who consider this option have a family history of breast cancer or a strong genetic predisposition for mutations that increase the risk of breast cancer. Bilateral prophylactic mastectomy is often the right choice for a woman who has a strong family history of breast cancer or a woman with a gene mutation that makes them susceptible to breast cancer. The more common gene mutations include BRCA1, BRCA2, CHEK2, NF1, ATM, CDH1, PALB2, PTEN, STK11, and p53. Women who have a strong family history of breast cancer are encouraged to undergo genetic testing.

Women with the BRCA1 mutation have a 55-65% chance of developing breast cancer by age 70. Those with BRCA2 have about a 45 percent chance of developing breast cancer by age 70. In comparison, women without the gene (general population) carry about a 7 percent chance of getting breast cancer by age 70. The recommendation for a woman who carries this gene is to have a preventative double mastectomy with breast reconstruction. These women should consider robotic nipple-sparing mastectomy with robotic breast reconstruction.

© Neil Tanna MD. All rights reserved.

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