Nipple-sparing mastectomy has been increasingly used for the surgical management of breast cancer. The procedure has been shown to be oncologically safe and improves patient psychosocial and sexual wellbeing outcomes. This reflection emphasizes that surgical management must consider the subjective patient experience.
LuigiBCarloVCorradoCOrlandoC. The nipple-areolar complex: anatomy, methods and pathologic findings, between senologist and dermatologist. J Ultrasound. 2023;26(1):239-247. doi:10.1007/s40477-022-00722-yEpub 2022 Sep 9. PMID: 36085438; PMCID: PMC10063719.
2.
VenuIvan den HeuvelMWongJP, et al.The breastfeeding paradox: relevance for household food insecurity. Paediatr Child Health. 2017;22(4):180-183. doi:10.1093/pch/pxx067Epub 2017 May 24. PMID: 29479210; PMCID: PMC5804629.
3.
GalimbertiVViciniECorsoG, et al.Nipple-sparing and skin-sparing mastectomy: review of aims, oncological safety and contraindications. Breast. 2017;34:S82-S84Epub 2017 Jun 30. PMID: 28673535; PMCID: PMC5837802.
4.
PlescaMBordeaCEl HoucheimiBIchimEBlidaruA. Evolution of radical mastectomy for breast cancer. J Med Life. 2016;9(2):183-186. PMID: 27453752; PMCID: PMC4863512.
5.
AngaritaFABrumerRCasteloMEsnaolaNFEdgeSBTakabeK. De-Escalating the management of in situ and invasive breast cancer. Cancers (Basel). 2022;14(19):4545. doi:10.3390/cancers14194545PMID: 36230468; PMCID: PMC9559495.
6.
De La CruzLMoodyAMTappyEEBlankenshipSAHechtEM. Overall survival, disease-free survival, local recurrence, and nipple-areolar recurrence in the setting of nipple-sparing mastectomy: a meta-analysis and systematic review. Ann Surg Oncol. 2015;22(10):3241-3249. doi:10.1245/s10434-015-4739-1Epub 2015 Aug 5. PMID: 26242363.
7.
WebsterAJShannoJNSanta CruzHS, et al.Oncologic safety of nipple-sparing mastectomy for breast cancer in BRCA gene mutation carriers: outcomes at 70 months median Follow-Up. Ann Surg Oncol. 2023;30(6):3215-3222. doi:10.1245/s10434-022-13006-wEpub 2023 Jan 5. PMID: 36604360.
8.
FrassonALFalconeABBarbosaF, et al.Low rate of complications in nipple-sparing mastectomy for patients with BRCA1 and BRCA2 mutation. Méd Sur. 2023;20(6):493-501. doi:10.2217/pme-2023-0084Epub 2023 Nov 1. PMID: 37909344.
9.
WoodwardSWillisALazarMBergerACTsangarisT. Nipple-sparing mastectomy: a review of outcomes at a single institution. Breast J. 2020;26(11):2183-2187. doi:10.1111/tbj.14088Epub 2020 Nov 2. PMID: 33137841.
10.
ValeroMGMuhsenSMooTA, et al.Increase in utilization of nipple-sparing mastectomy for breast cancer: indications, complications, and oncologic outcomes. Ann Surg Oncol. 2020;27(2):344-351. doi:10.1245/s10434-019-07948-xEpub 2019 Dec 10. PMID: 31823173; PMCID: PMC6952567.
11.
WuZYKimHJLeeJ, et al.Recurrence outcomes after nipple-sparing mastectomy and immediate breast reconstruction in patients with pure ductal carcinoma in situ. Ann Surg Oncol. 2020;27(5):1627-1635. doi:10.1245/s10434-019-08184-zEpub 2020 Jan 7. PMID: 31912259.
12.
BoydCJBekiszJMRameshS, et al.No cancer occurrences in 10-year Follow-up after prophylactic nipple-sparing mastectomy. Plast Reconstr Surg Glob Open. 2023;11(6):e5087.
13.
JakubJWPeledAWGrayRJ, et al.Oncologic safety of prophylactic nipple-sparing mastectomy in a population with BRCA mutations: a multi-institutional study. JAMA Surg. 2018;153(2):123-129. doi:10.1001/jamasurg.2017.3422PMID: 28903167; PMCID: PMC5838709.
14.
GarstkaMHenriquezAKellyBN, et al.How protective are nipple-sparing prophylactic mastectomies in BRCA1 and BRCA2 mutation carriers?Ann Surg Oncol. 2021;28(10):5657-5662. doi:10.1245/s10434-021-10445-9Epub 2021 Jul 22. PMID: 34296361.
15.
WeiCHScottAMPriceAN, et al.Psychosocial and sexual well-being following nipple-sparing mastectomy and reconstruction. Breast J. 2016;22(1):10-17. doi:10.1111/tbj.12542PMID: 26782950; PMCID: PMC4843778.
16.
BaileyCROgbuaguOBaltodanoPA, et al.Quality-of-Life outcomes improve with nipple-sparing mastectomy and breast reconstruction. Plast Reconstr Surg. 2017;140(2):219-226. doi:10.1097/PRS.0000000000003505PMID: 28746266.
17.
RomanoffAZaborECStempelMSacchiniVPusicAMorrowM. A comparison of patient-reported outcomes after nipple-sparing mastectomy and conventional mastectomy with reconstruction. Ann Surg Oncol. 2018;25(10):2909-2916. doi:10.1245/s10434-018-6585-4Epub 2018 Jul 2. PMID: 29968023; PMCID: PMC6205203.
18.
DjohanRGageEGatherwrightJ, et al.Patient satisfaction following nipple-sparing mastectomy and immediate breast reconstruction: an 8-year outcome study. Plast Reconstr Surg. 2010;125(3):818-829. doi:10.1097/PRS.0b013e3181ccdaa4PMID: 20195110.
19.
CoopeySBTangRLeiL, et al.Increasing eligibility for nipple-sparing mastectomy. Ann Surg Oncol. 2013;20(10):3218-3222. doi:10.1245/s10434-013-3152-xEpub 2013 Aug 22. PMID: 23975296.
20.
WuZYHanHHEomJSAhnSHKoB. Tumor-to-Nipple distance and the safety of nipple-sparing mastectomy. Plast Reconstr Surg. 2021;148(1):158e-159e. doi:10.1097/PRS.0000000000008011PMID: 34110325.
21.
AmburnTFarahaniSSevilimeduV, et al.Nipple discharge and pathologic involvement of the nipple-areolar complex: reconsidering guidelines for nipple-sparing mastectomy. Ann Surg Oncol. 2025;32(11):8434-8444. doi:10.1245/s10434-025-17931-4Epub 2025 Jul 29. PMID: 40730722.