Posters
Presentation Type
Poster
Discipline Track
Other
Abstract Type
Case Report
Abstract
Background: Mastectomies have long been used as a surgical treatment for malignant and benign disorders of the breast, both as a therapy and prophylaxis in high-risk patients. A nipple-sparing mastectomy (NSM) allows for removal of most of the glandular and ductal tissues while preserving the surface architecture of the nipple-areola complex (NAC). In satisfactory surgical candidates, this procedure allows for superior aesthetic outcomes compared to other mastectomy techniques and minimizes the need for additional procedures to reconstruct the nipple. Here, we summarize the established treatment standards and suggest an expansion of the established surgical techniques and selection criteria of NSM in the context of immediate-implant based breast reconstruction. We present two patients, and discuss the safety and efficacy of using hybrid-oncoplastic techniques to perform primary breast reconstruction in women undergoing NSM as non-ideal candidates.
Methods: Patient 1 is a 47-year-old woman with a positive family history of both breast cancer and BRCA mutation who underwent a prophylactic mastectomy. Patient 2 is a 41-year-old woman who had undergone extirpative therapy for her breast cancer. The patients have a BMI of 32 and 30 kg/m2 respectively as well as grade 2 ptosis which might otherwise disqualify them from NSM with immediate implant based reconstruction.
Results: Performing a NSM and immediate, implant based reconstruction of these non-ideal patients allows for us to achieve an aesthetically pleasing, repositioned nipple-areolar complex at the time of their extirpative operation and minimizes their need for multiple operations. Both patients are healing within normal limits with satisfactory aesthetic outcomes.
Conclusion: The superior aesthetic outcomes, the retention of the native NAC architecture, and the sparing of multiple additional operations make this hybrid technique an enticing option for patients and surgeons alike. Expanding the selection criteria to include these non-ideal candidates will allow for more patients to pursue a more aesthetically pleasing result in fewer stages. More research will be required In satisfactory surgical candidates.
Academic/Professional Position
Medical Student
Academic/Professional Position (Other)
MS3
Mentor/PI Department
Surgery
Recommended Citation
Dadzie, Aaron I. and Berry, Paul, "Oncoplastic Nipple Sparing Mastectomy and Immediate Reconstruction in Non-ideal Candidates" (2024). Research Symposium. 4.
https://scholarworks.utrgv.edu/somrs/2023/posters/4
Included in
Oncoplastic Nipple Sparing Mastectomy and Immediate Reconstruction in Non-ideal Candidates
Background: Mastectomies have long been used as a surgical treatment for malignant and benign disorders of the breast, both as a therapy and prophylaxis in high-risk patients. A nipple-sparing mastectomy (NSM) allows for removal of most of the glandular and ductal tissues while preserving the surface architecture of the nipple-areola complex (NAC). In satisfactory surgical candidates, this procedure allows for superior aesthetic outcomes compared to other mastectomy techniques and minimizes the need for additional procedures to reconstruct the nipple. Here, we summarize the established treatment standards and suggest an expansion of the established surgical techniques and selection criteria of NSM in the context of immediate-implant based breast reconstruction. We present two patients, and discuss the safety and efficacy of using hybrid-oncoplastic techniques to perform primary breast reconstruction in women undergoing NSM as non-ideal candidates.
Methods: Patient 1 is a 47-year-old woman with a positive family history of both breast cancer and BRCA mutation who underwent a prophylactic mastectomy. Patient 2 is a 41-year-old woman who had undergone extirpative therapy for her breast cancer. The patients have a BMI of 32 and 30 kg/m2 respectively as well as grade 2 ptosis which might otherwise disqualify them from NSM with immediate implant based reconstruction.
Results: Performing a NSM and immediate, implant based reconstruction of these non-ideal patients allows for us to achieve an aesthetically pleasing, repositioned nipple-areolar complex at the time of their extirpative operation and minimizes their need for multiple operations. Both patients are healing within normal limits with satisfactory aesthetic outcomes.
Conclusion: The superior aesthetic outcomes, the retention of the native NAC architecture, and the sparing of multiple additional operations make this hybrid technique an enticing option for patients and surgeons alike. Expanding the selection criteria to include these non-ideal candidates will allow for more patients to pursue a more aesthetically pleasing result in fewer stages. More research will be required In satisfactory surgical candidates.