Posters

Presenting Author

Allison Podsednik Gardner

Presentation Type

Poster

Discipline Track

Clinical Science

Abstract Type

Research/Clinical

Abstract

Background: Breast cancer is the most common malignancy in women aside from non-melanoma skin cancer. Skin Sparing Mastectomy (SSM) and preservation of the nipple areolar complex (NAC) are increasing in popularity due to improved cosmesis and low rate of tumor recurrence. Relative contraindications to nipple-sparing mastectomies (NSM) include grade II and III breast ptosis, even if oncologically feasible to keep the nipple, due to concerns of vascular compromise. For some women, maintaining their own, natural nipples is an important part of the reconstructive process. This paper describes a technique which is intended to preserve the NAC in those with large breast ptosis by locating NAC on the inferior flap and utilizing de-epithelization.

Methods: We aim to describe a new surgical technique to safely preserve the NAC during breast reconstruction in women with large grade II and III ptosis. In addition, we present data from women at our institution that have undergone the surgical technique as proof of its efficacy. Inclusion criteria was females at DHR who were candidates for NSM, underwent the technique presented in this paper, and were diagnosed with a minimum of grade II breast ptosis.

Results: Patients in the study had a mean age of 49.6 years old and had a BMI of 30.8. In our institution, this operation was performed on 17 patients and 31 breasts with a 83.87% NAC survival rate. NAC partial or full necrosis rate in NSM in unselected patient population is estimated to be between 2-20%. On average the follow up time for the patient population was 19 months with 45 months being the longest follow up time to date.

Conclusion: Utilizing a de-epithelialized inferior mastectomy skin flap to preserve the nipple-areolar complex in patients with stage II and III breast ptosis is a safe and reproducible technique of performing nipple sparing mastectomies.

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Description of a New Technique: Utilizing a De-Epithelialized Inferior Mastectomy Skin Flap to Preserve the Nipple-Areolar Complex in Patients with Stage II and III Breast Ptosis

Background: Breast cancer is the most common malignancy in women aside from non-melanoma skin cancer. Skin Sparing Mastectomy (SSM) and preservation of the nipple areolar complex (NAC) are increasing in popularity due to improved cosmesis and low rate of tumor recurrence. Relative contraindications to nipple-sparing mastectomies (NSM) include grade II and III breast ptosis, even if oncologically feasible to keep the nipple, due to concerns of vascular compromise. For some women, maintaining their own, natural nipples is an important part of the reconstructive process. This paper describes a technique which is intended to preserve the NAC in those with large breast ptosis by locating NAC on the inferior flap and utilizing de-epithelization.

Methods: We aim to describe a new surgical technique to safely preserve the NAC during breast reconstruction in women with large grade II and III ptosis. In addition, we present data from women at our institution that have undergone the surgical technique as proof of its efficacy. Inclusion criteria was females at DHR who were candidates for NSM, underwent the technique presented in this paper, and were diagnosed with a minimum of grade II breast ptosis.

Results: Patients in the study had a mean age of 49.6 years old and had a BMI of 30.8. In our institution, this operation was performed on 17 patients and 31 breasts with a 83.87% NAC survival rate. NAC partial or full necrosis rate in NSM in unselected patient population is estimated to be between 2-20%. On average the follow up time for the patient population was 19 months with 45 months being the longest follow up time to date.

Conclusion: Utilizing a de-epithelialized inferior mastectomy skin flap to preserve the nipple-areolar complex in patients with stage II and III breast ptosis is a safe and reproducible technique of performing nipple sparing mastectomies.

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