Quick blog, but I think these are important things to think about. If you have breast cancer and you do a mastectomy, how important is the nipple?
Sometimes you cannot preserve the nipple because the tumor is too close to the nipple, or if you are droopy you cannot safely do a mastectomy and lift the breast without losing the nipple. (NOTE: For those at high risk of breast cancer, sometimes doing a breast reduction is a great intermediate step before you get cancer. Not only does the reduction lift you and reduce the strain on your neck, back, and shoulders, but removing breast tissue makes your mammogram imaging easier by lowering the mass and density of the breast and having a breast reduction lowers your risk of breast cancer because you have removed breast tissue).
“Quality of Life and Complications after Nipple versus Skin Sparing Mastectomy followed by Immediate Breast Reconstruction: A systematic Review and Meta Analysis” was in the PRS Journal July 2023.
Nipple sparing mastectomy preserves the nipple. This study looked at 3895 patients in 13 studies.
What did they find?
- Significant difference in Sexual Well being and Psychosocial Well being in those who did nipple sparing mastectomies.
- There were no differences in overall complication rates between the two groups.
My takeaway?
The nipple seems to be important, shocking no one. But seeing the difference in how the women feel is impressive. Losing your nipple takes a big mental and sexual toll. I know from my training it is hard to reconstruct the nipple areola complex sometimes. If you can preserve your own, do it. The fact the complication rates were similar is great. I am sure there is some bias, as those who get nipple sparing mastectomies are not droopy and don’t have a tumor near the nipple, but still it is good to know.
Again, for those at high risk for breast cancer if you are large and droopy, consider a breast reduction BEFORE you get breast cancer. You cannot lift and do a mastectomy at the same time and preserve the nipple. And a breast reduction removes breast tissue, which 1. makes it easier to image your breast and 2. is actually taking out breast tissue (which we analyze in the lab) which lowers your risk for getting breast cancer.