Four Cases of Breast Cancer in which Nipple-sparing Mastectomy was Perfored without Primary Breast Reconstruction

Abstract

Nipple-sparing mastectomy (NSM) has increasingly been employed as a procedure that provides an excellent cosmetic benefit. However, it generally presupposes breast reconstruction. Herein, we report four patients with breast cancer who underwent NSM with omission of primary breast reconstruction between August 2008 and November 2010. Their mean age was 52 years, and their mammograms revealed calcification and extensive foci. A peri-areolar with lateral extension incision was performed in all the patients, whereas intraoperative frozen section diagnosis of the surgical margin on the nipple side was performed in three patients. The final pathological diagnosis was invasive ductal carcinoma in two patients and ductal carcinoma in situ (DCIS) in the other two patients. The margin on the nipple side of two of the four patients were also found to be histologically positive. Postoperative complications, including nipple necrosis and infection, were not observed. The postoperative level of satisfaction was high in all the patients, since they did not feel a sense of breast loss. There was one case of nipple recurrence during a follow-up period of ≥10 years, which resolved with local resection without relapse. Therefore, NSM without primary breast reconstruction can be a treatment option for selected cases, including extensive DCIS.