Abstract
The problem of nipple-areola complex (NAC) preservation during mastectomy is a very intriguing and stimulating issue. In fact, in order to perform an oncologically safe operation, no mammary tissue (enclosed in the main galactophoric ducts) should remain; on the other hand, without the blood supply coming from the breast gland, NAC viability is greatly impaired because the surrounding vascular dermal network is not developed enough to support its metabolic requirements. We suggest therefore a two-step surgical procedure. The first step, on an outpatient basis with local tumescent anesthesia, is a mini-invasive cutting and coagulating procedure. It addresses the autonomization of the vascular supply to the NAC by detaching the galactophore stalk from the nipple and coagulating the deep vascular plexus. The second step, under general anesthesia and again with tumescent technique, removes the breast within its capsule, with careful checks of any remnant and adequate approach to the axilla. A subpectoralis prosthesis completes the procedure. In our view, this technique is electively suitable for prophylactic mastectomy, but also for stage I breast cancer, 2.5 cm from the NAC and 1.5 cm from the skin and pectoralis fascia, and it is very safe, simple, and effective.
| Original language | English |
|---|---|
| Pages (from-to) | 173-178 |
| Number of pages | 6 |
| Journal | Breast Journal |
| Volume | 11 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - May 2005 |
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Keywords
- Delayed nipple-sparing modified subcutaneous mastectomy
- Mastectomy
- Nipple-areola complex preservation
ASJC Scopus subject areas
- Internal Medicine
- Oncology
Cite this
Delayed nipple-sparing modified subcutaneous mastectomy : Rationale and technique. / Palmieri, Beniamino; Baitchev, George; Grappolini, Simone; Costa, Alberto; Benuzzi, Giorgia.
In: Breast Journal, Vol. 11, No. 3, 05.2005, p. 173-178.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Delayed nipple-sparing modified subcutaneous mastectomy
T2 - Rationale and technique
AU - Palmieri, Beniamino
AU - Baitchev, George
AU - Grappolini, Simone
AU - Costa, Alberto
AU - Benuzzi, Giorgia
PY - 2005/5
Y1 - 2005/5
N2 - The problem of nipple-areola complex (NAC) preservation during mastectomy is a very intriguing and stimulating issue. In fact, in order to perform an oncologically safe operation, no mammary tissue (enclosed in the main galactophoric ducts) should remain; on the other hand, without the blood supply coming from the breast gland, NAC viability is greatly impaired because the surrounding vascular dermal network is not developed enough to support its metabolic requirements. We suggest therefore a two-step surgical procedure. The first step, on an outpatient basis with local tumescent anesthesia, is a mini-invasive cutting and coagulating procedure. It addresses the autonomization of the vascular supply to the NAC by detaching the galactophore stalk from the nipple and coagulating the deep vascular plexus. The second step, under general anesthesia and again with tumescent technique, removes the breast within its capsule, with careful checks of any remnant and adequate approach to the axilla. A subpectoralis prosthesis completes the procedure. In our view, this technique is electively suitable for prophylactic mastectomy, but also for stage I breast cancer, 2.5 cm from the NAC and 1.5 cm from the skin and pectoralis fascia, and it is very safe, simple, and effective.
AB - The problem of nipple-areola complex (NAC) preservation during mastectomy is a very intriguing and stimulating issue. In fact, in order to perform an oncologically safe operation, no mammary tissue (enclosed in the main galactophoric ducts) should remain; on the other hand, without the blood supply coming from the breast gland, NAC viability is greatly impaired because the surrounding vascular dermal network is not developed enough to support its metabolic requirements. We suggest therefore a two-step surgical procedure. The first step, on an outpatient basis with local tumescent anesthesia, is a mini-invasive cutting and coagulating procedure. It addresses the autonomization of the vascular supply to the NAC by detaching the galactophore stalk from the nipple and coagulating the deep vascular plexus. The second step, under general anesthesia and again with tumescent technique, removes the breast within its capsule, with careful checks of any remnant and adequate approach to the axilla. A subpectoralis prosthesis completes the procedure. In our view, this technique is electively suitable for prophylactic mastectomy, but also for stage I breast cancer, 2.5 cm from the NAC and 1.5 cm from the skin and pectoralis fascia, and it is very safe, simple, and effective.
KW - Delayed nipple-sparing modified subcutaneous mastectomy
KW - Mastectomy
KW - Nipple-areola complex preservation
UR - http://www.scopus.com/inward/record.url?scp=18644367289&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=18644367289&partnerID=8YFLogxK
U2 - 10.1111/j.1075-122X.2005.21520.x
DO - 10.1111/j.1075-122X.2005.21520.x
M3 - Article
C2 - 15871701
AN - SCOPUS:18644367289
VL - 11
SP - 173
EP - 178
JO - Breast Journal
JF - Breast Journal
SN - 1075-122X
IS - 3
ER -