Skin-sparing Mastectomy

I just read an article that said a lot of board-certified surgeons in CA reported they are still using traditional techniques for mastectomy, cutting across the whole breast and leaving unnecessary scars. Why would surgeons do that instead of using skin-sparing mastectomy technique? Is there any reason that would justify not performing a skin-sparing mastectomy in favor of a traditional (and disfiguring) mastectomy?

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Nipple-sparing mastectomy provides the ultimate cosmetic result in breast reconstruction

The default technique of the breast surgeons I usually choose to work with is nipple-sparing mastectomy (NSM). NSM is appropriate in the following situations: BRCA gene positive women seeking prophylactic mastectomy Women with a strong family history of breast cancer seeking prophylactic mastectomy Women with DCIS (non-invasive breast cancer) Women with small tumors at least 2 cm away from the nipple My most recent blog post details the technique... more

All breast cancers, like all breasts, are not the same

The choice of the type of incision for a mastectomy should first be aimed at treating the disease and second at getting the best cosmetic result. Cancers can be advanced, large, and found in larger breasted women, all of which do not lend themselves to a skin sparing approach. Remember, a longer incision does not necessarily equal a "disfiguring" operation when you take into account the whole purpose of the procedure: the cure of the cancer.

All breast cancers are not the same

Skin sparing mastectomies are a great advancement for breast cancer surgery. An extension of these is the nipple/areolar sparing mastectomy which give great results in the right patients. However, all breast cancers are not the same. Skin sparing mastectomy is best for small cancers that are not close to the skin. However, more severe cancers that are large or close to the skin, may require traditional modified mastectomy incisions. It is unclear from the report that you site whether... more

Skin sparing isn't for everyone

The best candidates for a skin sparing mastectomy are those with early breast cancers and small to medium sized breasts. Those with larger breasts are often better served with a traditional mastectomy.

Large tumors is one

Skin sparing mastectomies can be performed in many situations. Some situtations where you would not use this technique would be in patients with larger tumors close to the skin, and also in patients that have very ptotic (sagging) breasts.

Steven Wallach, MD

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Manhattan Plastic Surgeon

Skin sparing mastectomy allows much better reconstruction

When a woman is diagnosed with breast cancer, the most important thing is to treat the cancer appropriately. It goes without saying that breast reconstruction, although important, is not as important as curing the cancer. However, if an equivalent cancer operation can be performed, and limit the amount of skin removed with possible preservation of the areola and/or nipple, the aesthetic outcome of the reconstruction will be MUCH better. Skin sparing techniques can be... more

Mastectomy depends upon training and the cancer

Hello, When I assist in breast reconstruction for a patient, I prefer to be present during the Mastectomy to help with the skin sparing part if it is feasible. It is not always due to the nature of the cancer (size and location.) Not all general surgeons are comfortable performing skin sparing mastectomy or have the availability of plastic surgeons to help.