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Nipple-sparing mastectomy—is it worth the risk?

Nature Reviews Clinical Oncology volume 8, pages 742–747 (2011)Cite this article

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Abstract

Nipple-sparing mastectomy (NSM) is a surgical protocol designed to reduce the disabling psychological effects of radical or skin-sparing mastectomy. The preservation of the nipple–areola complex produces a more-natural result of the breast reconstruction, but this preservation is suspected of increasing tumor local recurrence. To reduce this risk, different approaches have been proposed: restrict the inclusion criteria and/or add localized radiation therapy. The local recurrence rate in recent series of patients receiving NSM is comparable with the local recurrence rate in modified radical or skin-sparing mastectomies. Today, the quality of the subcutaneous mastectomy technique allows for a more radical glandular removal, especially in the retroareolar area; therefore, local recurrence is observed in 3–6% of patients at 5 years, consistent with traditional mastectomy.

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Authors and Affiliations

  1. Division of Plastic Surgery, European Institute of Oncology, Via Ripamonti 435, Milan, 20141, Italy

    Jean-Yves Petit, Visnu Lohsiriwat, PierCarlo Rey, Stefano Martella, Cristina Garusi, Francesca De Lorenzi, Andrea Manconi & Mario Rietjens

  2. Division of Breast Surgery, European Institute of Oncology, Via Ripamonti 435, Milan, 20141, Italy

    Umberto Veronesi

  3. Division of Medical Oncology, European Institute of Oncology, Via Ripamonti 435, Milan, 20141, Italy

    Giuseppe Curigliano

  4. Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, Milan, 20141, Italy

    Edoardo Botteri

  5. Division of Psyco-Oncology, European Institute of Oncology, Via Ripamonti 435, Milan, 20141, Italy

    Florence Didier

  6. Division of Radiology, European Institute of Oncology, Via Ripamonti 435, Milan, 20141, Italy

    Roberto Orecchia

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  1. Jean-Yves Petit
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Contributions

J.-Y. Petit, V. Lohsiriwat, P. Rey, G. Curigliano and E. Botteri contributed to researching the data for the article. All authors made a substantial contribution to the discussion of the content. J.-Y. Petit, V. Lohsiriwat, P. Rey and G. Curigliano wrote the article and J.-Y. Petit, V. Lohsiriwat, P. Rey, G. Curigliano, R. Orecchia and M. Rietjens reviewed and edited the manuscript prior to submission.

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Correspondence to Jean-Yves Petit.

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U. Veronesi acts as a consultant to the Istituto Europeo Oncologia. The other authors declare no competing interests.

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Petit, JY., Veronesi, U., Lohsiriwat, V. et al. Nipple-sparing mastectomy—is it worth the risk?. Nat Rev Clin Oncol 8, 742–747 (2011). https://doi.org/10.1038/nrclinonc.2011.159

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