Nipple-Sparing Mastectomy: A Modern Approach to Breast Cancer Surgery

Thanks to advances in breast cancer research and personalized treatment approaches, patients diagnosed with breast cancer now have more surgical options than ever before. Among these innovative approaches is the Nipple-Sparing Mastectomy (NSM)—a procedure that not only removes the cancerous tissue but also preserves the nipple and much of the breast’s natural appearance.

Nipple-Sparing Mastectomy (NSM) is a surgical option for patients requiring a mastectomy, in which the breast tissue is removed while the skin, nipple, and areola remain intact. This procedure allows for immediate reconstruction and offers a more natural post-surgery result, giving patients both peace of mind and a sense of body confidence.

“In the past, patients with breast cancer had fewer options, often facing radical mastectomies that involved not only the removal of breast tissue but also the skin, lymph nodes, and chest muscles,” notes M. Michele Blackwood, MD, FACS, director of Breast Surgery and director of Women’s Oncologic Health, RWJBarnabas Health and Rutgers Cancer Institute; and Head of Breast Surgery at Cooperman Barnabas Medical Center. “While these procedures were life-saving, they could leave patients with significant physical and emotional scars.”

However, with Nipple-Sparing Mastectomy, advancements in understanding cancer biology and the ability to detect cancers earlier have allowed surgeons to shift toward breast conservation.

How Nipple-Sparing Mastectomy WorksDuring NSM, the surgeon carefully removes the breast tissue while preserving the skin, nipple, and areola. This requires precision to ensure that all cancerous cells are removed while keeping the remaining tissue healthy.

“One of the benefits of NSM is the option for immediate breast reconstruction, which can be done using either implants or tissue from another part of the body, such as in the DIEP flap procedure, which also provides a mini tummy tuck effect,” says Dr. Blackwood. “Some patients may also benefit from oncoplastic surgery, which combines the removal of the tumor with plastic surgery techniques to improve the overall aesthetic result.”

Benefits of Nipple-Sparing MastectomyPatients who qualify for NSM can experience both physical and emotional benefits:

• Preservation of Natural Appearance: By keeping the nipple and breast skiNipple-Sparing Mastectomyn intact, the breast can be reconstructed in a way that looks and feels more natural.
  
• Improved Self-Esteem: Many women report feeling more confident and secure after undergoing NSM because they retain a sense of wholeness.
• Reduced Scarring: With fewer incisions and the ability to hide scars, patients experience less noticeable post-surgery marks.

Not all breast cancer patients are candidates for NSM. Factors such as the size and location of the tumor, as well as the overall health of the patient, play a role in determining eligibility. Patients should have tumors that are small, non-invasive, and located away from the nipple. Surgeons also consider whether the cancer has spread to the lymph nodes or skin.

The Future of Breast Cancer SurgeryThe field of breast cancer surgery continues to evolve, with a focus not only on removing the cancer but also on the quality of life for survivors. Surgeons are now integrating breast preservation and cosmetic outcomes into their treatment plans, ensuring that patients receive the best possible care in terms of both survival and appearance.

Nipple-Sparing Mastectomy represents a significant step forward in breast cancer treatment, providing patients with a chance to maintain a natural look while effectively treating their disease. “Thanks to advances in research and surgical techniques, women facing a breast cancer diagnosis now have options that not only focus on survival but also on long-term well-being and self-confidence,” said Dr. Blackwood.