The AAPS 102nd Annual Meeting

Extreme Nipple-sparing Mastectomy: Feasibility Of Nipple Preservation and Immediate Reconstruction In Large Breasts (≥ 600 grams)

Casey Zhang, BS1, Elizabeth A Moroni, MD MHA1, Vaishali Purohit, MD2, Jasmine Dwyer, MD2, Suzanne Coopey, MD2, Andrea Moreira, MD1,3

1University of Pittsburgh Medical Center, Pittsburgh, PA, USA, 2Division Breast Surgical Oncology, Department of Surgery, Allegheny Health Network, Pittsburgh, PA, USA, 3Division of Plastic Surgery, Department of Surgery, Allegheny Health Network, Pittsburgh, PA, USA

Background

•Nipple-sparing mastectomy (NSM) offers aesthetically pleasing and favorable quality-of-life outcomes

•Multiple studies have demonstrated the oncologic safety of NSM relative to skin-sparing mastectomy (SSM)

•Concerns remain about the feasibility of NSM with immediate reconstruction in patients with large-volume breasts (≥ 600g)

Purpose

The purpose of this study is to compare complication rates between patients undergoing NSM vs. SSM with resection weights of ≥ 600g per breast.

Methods

Inclusion Criteria:

•Women undergoing prophylactic or therapeutic SSM or NSM with immediate reconstruction between 2020-2022

•Breast resection weight ≥ 600g

Outcomes:

•Minor complications: seroma, hematoma, skin flap necrosis, nipple necrosis, wound dehiscence, infection

•Major complications: minor complications requiring return to OR

Conclusion

•In large-breasted patients, there is a >20% chance of developing a complication requiring additional surgery regardless of the approach to the nipple-areolar complex.

•NSM patients in our series exhibited a lower incidence of minor complications than their SSM counterparts.

•NSM in breasts ≥ 600g presents an acceptably low rate of nipple necrosis, similar to that of smaller-breasted patients.

•Women with breast volumes larger than 600g can be safely offered NSM.

The AAPS 102nd Annual Meeting

Extreme Nipple-sparing Mastectomy: Feasibility Of Nipple Preservation And Immediate Reconstruction In Breasts >600 Grams

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