Research Summary: Breast Surgery

Jan. 18 -- With a trend in post breast cancer reconstruction to conserve as much skin as possible; the Nipple Sparing Mastectomy not only spares skin but also spares the areola and nipple. This relatively new surgery technique is gaining popularity around the world and is welcome relief to millions of women who see the loss of their nipples and areola as the most difficult to lose; these define the appearance of the breast and can provide significant self esteem reinforcement and sexual confidence.

For mastectomies that involve breasts with high stage cancer, skin and muscle must be removed in order to remove the cancerous cells. The Nipple Sparing technique however, is done on patients who are in very early stages such as DCIS, on breasts with very small tumors, or on women who choose to have a mastectomy as a preventative prophylactic measure because the have a family history of developing breast cancer and are carrying the BRCA gene.

This new technique is not widely known but for the properly selected patient it can be a real improvement to normal breast cancer surgical options. The technique involves an implant of ½ saline and ½ silicone that is implanted under the skin, without affecting the muscle or the areola or nipple. Women who undergo this surgery have the skin under the areola and nipple tested by a pathologist while the patient is undergoing surgery however, the incidence of cancer detection in the areola or nipple area in patients with DCIS or prophylactic surgery is extremely low.

The excellent cosmetic results of retaining the areola and nipple help the patients deal with the psychological effects of breast surgery and cancer. Although the cosmetic benefits of this procedure are remarkable, sensitivity of the nipple is diminished or absent for most patients.

The Nipple Sparing surgery is growing as with DCIS story is very good. The numbers of DCIS detection are on the rise. Actually, as a result of screening detection, the incidence of DCIS has gone up dramatically. DCIS cancer diagnosis comprise a lot of the breast cancer cases that are detected through mammography, over 60,000 women a year; about 15% of all breast cancer cases. Interestingly enough I have 5 friends, not including my sister and aunt who had a DCIS cancer diagnosis and mastectomies. I know 2 women who opted for prophylactic surgery due to their BRCA gene detection. So, if my radar has this incidence of close friends and family facing these surgeries; then the rest of the city does too.

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