Journal article
Extreme Nipple-Sparing Mastectomy: Feasibility of Nipple Preservation and Immediate Reconstruction in Breasts Weighing Over 600 Grams in a Cohort of 43 Patients
The breast journal, v 2025(1), 6974079
01 Jan 2025
PMID: 40026848
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Limited data exist on complication rates in nipple-sparing mastectomy (NSM) in patients with large-volume breasts. Our aim was to evaluate the early complication rates of NSM with immediate reconstruction in a consecutive cohort of patients with large-volume breasts. Methods: After IRB approval, patients treated with prophylactic or therapeutic NSM and immediate reconstruction from January 2020 to June 2022 at our health network were identified. Patients with breast weights > 600 g (the extreme NSM group) were compared to patients with breast weights of 600 g or less (the average-volume NSM group). Results: A total of 184 patients underwent NSM with immediate reconstruction. Forty-three of 184 (23.37%) NSM patients had breast weights > 600 g. Of these, 30 patients had bilateral NSM, for a total of 73 breasts with volumes over 600 g, ranging from 603 to 1658 g. There were significantly more total complications in the extreme NSM compared to average-volume NSM groups (41.86% vs. 21.99%, p = 0.009852). When broken down into major and minor complications, the extreme NSM group had significantly more major complications than the average-volume NSM group (27.91% vs. 12.86%, p = 0.01072), but no difference in minor complications (13.95% vs. 9.29%, p = 0.2205). Overall, one (2.33%) patient in the extreme NSM group had a reconstruction failure, compared to three (2.14%) in the average-volume NSM group. Only two of 43 (4.65%) patients in the extreme NSM group lost their nipples due to total or partial nipple necrosis. Conclusions: NSM with immediate reconstruction was successful in the majority of patients with large-volume breasts. The rate of nipple loss was acceptably low. Women with breast volumes larger than 600 g who are motivated to save their nipples at the time of mastectomy could be offered NSM.
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Details
- Title
- Extreme Nipple-Sparing Mastectomy: Feasibility of Nipple Preservation and Immediate Reconstruction in Breasts Weighing Over 600 Grams in a Cohort of 43 Patients
- Creators
- Vaishali Purohit - Allegheny Health NetworkJasmine Dwyer - Allegheny Health NetworkAndrea Moreira - University of Pittsburgh Medical CenterJenna Li - Allegheny Health NetworkEmil Fernando - Allegheny Health NetworkJanette Gomez - Allegheny Health NetworkJennifer Saldanha - Allegheny Health NetworkThomas Julian - Allegheny Health NetworkSuzanne Coopey (Corresponding Author) - Allegheny Health Network
- Publication Details
- The breast journal, v 2025(1), 6974079
- Publisher
- Wiley
- Number of pages
- 8
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:001432161100001
- Scopus ID
- 2-s2.0-86000264854
- Other Identifier
- 991022197320104721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Obstetrics & Gynecology
- Oncology