Nipple-Sparing Mastectomy Is Improving the Care of Patients with Breast Cancer


Dr. Tara L. Huston and Dr. Christine R. Rizk

Tara L. Huston, MD, of the Plastic and Reconstructive Surgery Division, and Christine R. Rizk, MD, of the Breast and Oncologic Surgery Division, recently attended the BC3 Breast Cancer Coordinated Care Conference, held in Washington.

The knowledge they gained at this interdisciplinary conference confirmed the value of their use of nipple-sparing mastectomy in selected patients.

A national meeting uniquely focused on coordinated interdisciplinary care, the BC3 conference was the first of its kind, bringing together renowned breast surgeons, reconstructive surgeons, and radiation oncologists in order to discuss current issues in the care of patients who have been diagnosed with, or at risk for, breast cancer. The goal was to improve the coordination and delivery of care.

The novel nipple-sparing mastectomy, already performed here at Stony Brook Medicine
by Drs. Rizk, Huston, and their colleagues, is gaining momentum across the country.

In a traditional mastectomy, the breast gland is removed along with the nipple and areola. However, in a nipple-sparing mastectomy, the nipple and areola are preserved along with all of the skin of the breast.


Click on image for brochure.

"In carefully selected patients, this approach may significantly improve the cosmetic result by allowing the breast to maintain its virtual appearance," says Dr. Huston. "Preservation of the nipple-areolar complex has important implications for the well-being of our female patients."

Research has demonstrated improved psychosocial well-being, sexual function, and overall satisfaction with aesthetic outcome.

Studies from Memorial Sloan-Kettering Cancer Center, Georgetown University, and the Cleveland Clinic have demonstrated that nipple-sparing mastectomy is equally as effective in the treatment of cancer when compared to earlier, more aggressive surgeries.

A recent report from Sloan-Kettering concludes: "The trends demonstrate the increasing acceptance of nipple-sparing mastectomy (NSM) as a prophylactic procedure as well as for therapeutic purposes. Although NSM is not standard, our experience supports the selective use of NSM in both prophylactic and malignant settings."

Approximately half of the women who undergo nipple-sparing mastectomy do eventually appear to regain some sensation in the nipple-areolar complex.

Even if sensation does not return, the great majority feel that preserving their native nipple-areolar complex helps to maintain self-esteem and positive body image.

"Nipple-sparing mastectomy may afford patients the best possible cosmetic outcome without sacrificing cure," says Dr. Rizk. "Candidates for the nipple-sparing mastectomy include women undergoing surgery for prevention of breast cancer, and those with small tumors located away from the center of the breast."

Also this month, Stony Brook's Carol M. Baldwin Breast Care Center was granted a full three-year reaccreditation by the National Accreditation Program for Breast Centers (NAPBC; a program administered by the American College of Surgeons).

Our breast center was the first in New York to gain this quality-assurance designation. A breast center that earns NAPBC accreditation has demonstrated a firm commitment to offer its patients every significant advantage in their battle against breast disease.

Click here to read the abstract of the 2011 study, "Nipple-Sparing Mastectomy for Breast Cancer and Risk-Reducing Surgery: The Memorial Sloan-Kettering Cancer Center Experience."