Mastectomy Can Safely Spare Nipple for Some Women

Women who have mastectomies to limit the risk that breast cancer will spread or come back often lose their nipples along with the breast.

Now a study suggests that some of those women may be able to have surgeries that leave their nipples intact, and allow for more straightforward reconstruction of the breast in plastic surgery.

Surgeons say that such procedures lead to a better appearance, study co-author Dr. Elena Brachtel, of Massachusetts General Hospital, told Reuters Health.

To determine whether nipple-sparing mastectomies could be safe, Brachtel and her colleagues looked at 230 mastectomies performed at their hospital to see how many nipples that were removed as part of the surgeries were free of cancer. Most - about 80 percent - were, they report in the Journal of Clinical Oncology.

When they looked at 84 mastectomies that were done in women who didn't have a cancer diagnosis but who had the surgery because their risk for breast cancer was very high, none of the nipples were cancerous. Just three nipples showed evidence of lobular carcinoma in situ, a precancerous condition.

Based on these and other study findings that predicted whether a given nipple was likely to be affected by cancer, the decision on the approach to be taken eventually rests with the surgeon and the patient — but under certain circumstances and with certain tumor characteristics, the risk may be considered low enough to allow preservation of the nipple, Brachtel said.

In an accompanying editorial, Dr. Stephen B. Edge of Roswell Park Cancer Institute, Buffalo, New York calls for more long-term data, but says the study was well-done.