Nipple-sparing mastectomy

October 25, 2013

Breast Cancer Prevention: Prophylactic Nipple-Sparing Mastectomy

Blog, Breast Cancer, Breast Reconstruction, Breast Reconstruction atlanta breast specialist, board certified plastic surgeon Alpharetta, breast cancer, breast cancer removal, breast cancer surgery atlanta, breast reconstruction alpharetta, breast reconstruction Atlanta, breast surgeon atlanta, mastectomy atlanta, Nipple-sparing mastectomy

Several breast reconstruction options exist to remove breast cancer or reduce associated risks. One of those options is a prophylactic mastectomy procedure, which preventatively removes one or both breasts to prevent or reduce the risk of breast cancer development. For any patient, it is important to review the available choices for these types of procedures as well as your motivation for surgery. Because breast cancer surgery is life changing, board certified plastic and reconstructive surgeon Dr. Franklyn Elliott encourages patients to choose the option they are most comfortable with to maximize satisfaction with the results. Passionate about helping breast cancer patients, Dr. Elliott presents patients with their options as well as what to expect during recovery and results during a reconstructive surgery consultation.

When it comes to breast cancer surgery, some women choose bilateral mastectomies over unilateral mastectomies, which can lead to a more symmetrical, balanced result when it comes to the reconstruction that follows. Dr. Elliott provides options for breast reconstruction, including tissue flap reconstruction, fat transfer, and breast reconstruction using a breast implant.

Generally, a bilateral prophylactic mastectomy will be planned to spare both nipple and areola. The incision for the nipple-sparing mastectomy is made around the areola. A small amount of tissue under the nipple areolar is removed and examined during surgery for the presence of any cancer cells. If breast cancer cells are found in the tissue removed, the entire nipple areolar is removed. Patients can elect to have nipple and areola reconstruction surgery after healing if this route is taken.

Reasons why one may choose a prophylactic mastectomy vary: already having cancer in one breast, a family history of breast cancer, abnormal cells on previous biopsy, positive genetic testing, and/or and the presence of dense breasts. If a patient has been referred to a plastic surgeon, chances are they have identified one or more of these risk factors with a surgeon, oncologist, or specialist post-screening.

In a recent study of patients electing preventative mastectomy, only 5% of women expressed regret. It’s important for women choosing to undergo these extensive surgical procedures to understand that post-operative breasts may not be the same as their original breasts. While Dr. Elliott can offer his expertise in helping you feel comfortable with your surgery, ultimately, the chosen option for preventative mastectomy is exclusively your decision to make.

Please contact us to make an appointment for a consultation with Dr. Elliott to discuss your goals after conferring with your surgeon, oncologist, or specialist. To learn more about the breast reconstruction procedures Dr. Elliott performs, please visit his website and follow him on Facebook, Twitter, and Google +.

March 23, 2012

Prophylactic Nipple-Sparing Mastectomy and Methods of Reconstruction

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Though once popular in the 70s and 80s, the prophylactic mastectomy fell out of favor with doctors and patients in the 90s. However, the advances of mammography in the 90s and beyond have lessened the number of women who are choosing to have one or both of their breasts removed to prevent the advent or spread of breast cancer.

Fewer people are as supportive of preventative mastectomies nowadays because of the potential complications and reports of low patient satisfaction. Thinner skin used over implants can cause capsular contracture or hardening of the tissue lining surrounding the implant.

In a chapter written for the textbook Surgery of the Breast, Dr. Franklyn Elliott writes regarding patient satisfaction:

Patients did not believe they were properly prepared for some of the results of these major surgical procedures, and because they did not have frank breast cancer, were not in the mind-set to deal properly with major surgical extirpation and reconstruction.

However, in a recent study only 5% of patients regretted undergoing prophylactic mastectomy and reconstruction surgery. Many felt that were inadequately prepared for the pain and incapacitation of the recovery period.

For this reason, it’s important that a plastic surgeon is one of the many consulting surgeons who advise a potential mastectomy and breast reconstruction patient.

Many women who are at a high risk for potential breast cancer and those who’ve had one breast removed because of cancer seek preventative mastectomies. There are many factors that oncologists, general surgeons, and plastic surgeons should consider before suggesting a prophylactic mastectomy for a patient including heredity, the breast cancer gene (BRCA1 and BRCA2), previous diagnoses, and more. It must also be explained to patients that advances in mammography techniques have made it easier to track potential cancers without removing the entire breast.

Choosing a preventative unilateral or bilateral mastectomy is a difficult choice for any woman. According to the chapter written by Dr. Elliott, the “plastic surgeon must limit his or her role to the very accurate description of the patient’s options after mastectomy and, equally important, a full and complete discussion of the recovery phase and the expected result.”

Oftentimes, prophylactic mastectomy patients are shown before and after pictures of women who have had breast cancer and undergone mastectomy and breast reconstruction surgery. It’s important that patients are given information specific to their particular procedure, regardless of the similarities between their procedures and another patient’s.

It’s rare that women with no risk factors are interested in prophylactic mastectomies with reconstructions. Some patients are motivated by fear. However a lack of risk factors in patients seeking prophylactic mastectomies probably means that they should not be considered for surgery.

Though controversial among some doctors and patients, there are benefits to preventative mastectomy and breast reconstruction. In the chapter, Dr. Elliott concludes, “With the variety of techniques available for breast reconstruction, intelligent management of the overlying skin, and gradual formation of the breast mass itself, patients can be increasingly assured of complete or near complete breast tissue removal and safe, predictable, uncomplicated breast reconstruction.”

To read the chapter, click here (link to PDF). Other articles written and used by Dr. Franklyn Elliott can be found on his articles page. You can also connect with him on Facebook and Twitter for the latest in plastic and reconstructive surgery news.