Nipple-Sparing Mastectomy

Overview

A mastectomy is a type of surgery used to treat breast cancer. During the surgery, all of the breast tissue is removed. In the past, this surgery caused a long, unsightly scar across the chest. Now, less invasive methods are used to help prevent a long scar.

A nipple-sparing mastectomy leaves in place most of the healthy breast skin, the nipple and the areola. Only the tissue contained within the envelope of skin around the breast is removed.

For you to have this operation, your cancer must not be in the nipple or tissue just underneath the nipple.

This method is used only if the patient is having immediate breast reconstruction. If the patient plans to wait before undergoing reconstructive surgery, the breast skin will be removed in order to ensure the scar and chest surface are flat.

The general events on the day of surgery will include the following:

1. When you get to the hospital, you’ll change into a hospital gown.
2. The surgical team will explain the surgery and answer any of your questions.
3. You will be taken to the operating room and given general anesthesia to make you fall asleep.
4. Once you’re asleep, the surgeon will make an opening in the skin.
5. The whole tumor will be removed through the opening, along with all the breast tissue.
6. Samples of the tissue and lymph nodes will be sent to the laboratory for analysis.
7. The reconstructive surgeon will reshape the remaining skin. The breast will be reconstructed using implants, your own tissue or even temporary chest expanders.
8. The opening is closed. A small plastic tube may be sewn into place in order to allow the surgery site to drain fluid.

Risks associated with a mastectomy include:

• Bleeding
• Infection
• Pain
• Swelling in the arm, known as lymphedema
• Hard scar tissue at the area of the surgery
• Shoulder pain and stiffness
• Numbness
• Buildup of fluid at the surgery site
• Tissue damage (skin or nipple)

There are a couple of options for the breast reconstruction portion of the surgery:

• Temporary expanders. These are saline-filled implants that are expandable. They are placed behind the muscles of the chest wall. Over time, fluid is injected into the expander to fill the space that a permanent implant will eventually occupy.
• Breast implants. These are placed in the area that once held the breast tissue. These implants can be made of synthetic materials such as silicone.
• Tissue flap. Some women may be able to use tissue or fat from other areas of their body to reconstruct the breast shape.

Get general information about your surgery and procedure.