Total skin-sparing mastectomy without preservation of the nipple-areola complex

Aaron G. Margulies, Julio Hochberg, Julie Kepple, Ronda S. Henry-Tillman, Kent Westbrook, Vicki Klimberg

Research output: Contribution to journalArticle

103 Citations (Scopus)

Abstract

Background: We hypothesized that total skin-sparing mastectomy (TSM) including where the skin overlying the nipple and areola is preserved would be oncologically safe and facilitate improved cosmetic reconstruction. Methods: A review (May 2003 through January 2005) was completed on all procedures that were performed through an inframammary incision or a previous scar with reconstruction using Botox, AlloDerm, and a subpectoral tissue implant. Results: Thirty-one patients had 50 TSMs. Twelve percent (6/50) of TSMs had the skin of the nipple and areola resected: 4 (14% of tumors) because of tumor involvement and 2 (4%) because of skin necrosis. Fourteen percent of patients had other complications: 4% (2/50) had infection and/or flap necrosis and 10% (5/50) had superficial epidermolysis requiring no intervention, for a total complication rate of 18%. Average cosmetic score was 8.5 (range 4 to 10). No recurrences are evident after mean follow-up of 7.9 ± 5.4 months. Conlusion: Our short-term experience suggests that TSM has an acceptable complication rate, is theoretically oncologically safe, and facilitates an improved cosmetic result.

Original languageEnglish (US)
Pages (from-to)907-912
Number of pages6
JournalAmerican Journal of Surgery
Volume190
Issue number6
DOIs
StatePublished - Dec 2005
Externally publishedYes

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Nipples
Mastectomy
Skin
Cosmetics
Necrosis
Cicatrix
Neoplasms
Recurrence
Infection

Keywords

  • AlloDerm
  • Botox
  • Breast reconstruction
  • Nipple involvement
  • Nipple-areolar complex
  • Skin-sparing mastectomy

ASJC Scopus subject areas

  • Surgery

Cite this

Total skin-sparing mastectomy without preservation of the nipple-areola complex. / Margulies, Aaron G.; Hochberg, Julio; Kepple, Julie; Henry-Tillman, Ronda S.; Westbrook, Kent; Klimberg, Vicki.

In: American Journal of Surgery, Vol. 190, No. 6, 12.2005, p. 907-912.

Research output: Contribution to journalArticle

Margulies, AG, Hochberg, J, Kepple, J, Henry-Tillman, RS, Westbrook, K & Klimberg, V 2005, 'Total skin-sparing mastectomy without preservation of the nipple-areola complex', American Journal of Surgery, vol. 190, no. 6, pp. 907-912. https://doi.org/10.1016/j.amjsurg.2005.08.019
Margulies, Aaron G. ; Hochberg, Julio ; Kepple, Julie ; Henry-Tillman, Ronda S. ; Westbrook, Kent ; Klimberg, Vicki. / Total skin-sparing mastectomy without preservation of the nipple-areola complex. In: American Journal of Surgery. 2005 ; Vol. 190, No. 6. pp. 907-912.
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