Nipple Sparing Mastectomy - Breast Cancer Options

A nipple sparing mastectomy is one method of performing this surgical procedure. The surgical term "mastectomy" is used for several variations of the procedure. It may involve removing one or both breasts, portions, or incising regions in the armpits in order to take out the lymph nodes. These operations are done to get rid of breast cancer in the early or later stages. This disease often begins in the milk ducts and is then called ductal carcinoma. Although certain risk factors point to an increased chance of developing this disease, doctors aren't really sure why some women get it and others don't. Here are some different types of mastectomies:

- Nipple sparing: This operation entails removing tissue but leaving the skin, nipple and areola. The chest wall muscles are often left, as well. Biopsies of the lymph systems may be performed simultaneously and the bosom is reconstructed right away.

- Skin sparing: In this version, which is appropriate for small tumors, the nipple and areola are removed as well as tissue but the outer skin is left intact. With this technique, reconstruction would be done at the same time.

- Total: A total or simple version is when the entire breast is removed. Biopsy would be done at the same time in order to examine the sentinel lymph region.

- Modified radical: This is one of the more complete variations of this operation. A surgeon would remove all skin, tissue, nipple, areola, chest muscles and even part of the wall. Lymph systems in the armpits would also be targeted.

Each of these operations would be done in patients who have been diagnosed with breast cancer. This disease is now considered the most common of cancers in U.S. women besides skin cancer. Other treatments that are often performed simultaneously include chemotherapy and radiation. While a plastic surgeon would perform a nipple sparing mastectomy and reconstructive operations, different doctors would oversee the chemotherapy and radiation. An oncologist is the chemo prescriber and the radiologist would oversee the radiation. Some reconstruction possibilities include:

- Implants: A plastic surgeon can reconstruct the region with medical devices called implants. These are filled with either silicone or saline solution. They may be placed immediately or in a later surgery after an expander has been used to stretch the skin.

- Flap surgeries: There are various flap methods that surgeons use to move skin and tissue from one region to the chest to create mounds that resemble breasts. There are DIEP, TRAM and Latissimus flap procedures. The regions where tissue is brought from may be the abdomen or the back.

- Nipple reconstruction: If the nipple wasn't spared, there are ways to recreate a nipple and areola after the original operation has healed. A doctor may take a tuck with a suture or cut a star-like incision in the area. A tattoo in a deeper skin tone would be applied to create the areola.