Nipple sparing mastectomies are awesome if you can do them. Nothing looks like a nipple in a reconstructed breast like your original nipple does. But they aren’t options for everyone. If you are doing a prophylactic mastectomy (think high risk patient or BRCA positive), nipple sparing mastectomies are a great choice. If you have breast cancer though, can you do one?
When is a nipple sparing mastectomy not indicated? This is taken from my recent CME (continuing medical education) course.
Exclusion criteria for nipple sparing mastectomy:
- tumors bigger than 3 cm
- clinical invasion of the nipple areola complex
- tumors within 2 cm of the nipple
- evidence of multicentric disease
- positive intraoperative retroareolar frozen section (* this means during the surgery they remove a small bit of tissue that goes up into the areola. If they find cancer cells in this, you must have your nipple removed.)
- disease in the lymph nodes
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