Oncological safety of prophylactic breast surgery: skin-sparing and nipple-sparing versus total mastectomy

Gland Surg. 2015 Dec;4(6):467-75. doi: 10.3978/j.issn.2227-684X.2015.02.01.

Abstract

Women with a BRCA1/2 gene mutation and others with a high breast cancer risk may opt for bilateral prophylactic mastectomy. To allow for immediate breast reconstruction the skin envelope is left in situ with or without the nipple-areola complex (NAC). Although possibly leading to a more natural aesthetic outcome than the conventional total mastectomy, so-called skin-sparing mastectomies (SSM) and nipple-sparing mastectomies (NSM) may leave some breast glandular tissue in situ. The oncological risk associated with remaining breast glandular tissue is unclear. We present a case of primary breast cancer after prophylactic mastectomy followed by a review of the literature on remaining breast glandular tissue after various mastectomy techniques and oncological safety of prophylactic mastectomies.

Keywords: Risk-reduction; breast glandular tissue; nipple-sparing mastectomy (NSM); primary breast cancer; skin-sparing mastectomy (SSM); terminal duct lobular units; total mastectomy.

Publication types

  • Review