(GEORGETOWN, D.C.) -- A new study published in the journal Plastic and Reconstructive Surgery found that some women who need a lumpectomy or mastectomy have another safe option with NSM -- nipple sparing mastectomy -- which doctors said offered patients breasts with a more natural look and feel when compared to other forms of mastectomy.
"Nipple sparing mastectomy as compared to other forms of mastectomy is becoming more common, and the surgery is usually successful in terms of achieving good breast reconstruction with a low risk of complications," said Dr. Scott Spear, chairman of the department of plastic surgery at Georgetown University Hospital and co-author of the study.
"There's a low risk of finding breast cancer or disease beneath the nipple in those patients who are offered nipple sparing mastectomy."
One of the main concerns with keeping the skin and nipple intact is the potential for cancer recurrence in the future. With that in mind, researchers reviewed the 169 NSM surgeries performed over 20 years at Georgetown University Hospital. They found there were no cancer recurrences and no new cancers on average for two and a half years after women underwent the procedure.
"There have been psychological studies to assess how women feel after having nipple sparing surgery compared to when the nipples have been removed," said Spear. "There is a dramatic difference shown that women are psychologically better off, in terms of self-esteem and sense of self, than those who have had the nipple removed. One of the appeals to this surgery is that you don't have to remove the breast skin and the nipple so it's similar to breast conservation."
But not every woman who needs a mastectomy is eligible for NSM. The procedure is dependent on several factors, including the size of the cancer, the size of the breast and the location of the cancer within the breast.
Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, agreed that the procedure is a good one for some patients who qualify, but he also expressed worry over the seemingly growing trend for women undergoing extreme surgeries, such as mastectomies, when they may have lesser invasive surgical options for their breast cancer treatment.
"There is some evidence that excellent reconstruction options is one reason more and more women are choosing bilateral mastectomy," said Dr. David Euhus, professor of surgical oncology at University of Texas Southwestern Medical Center. "The nipple-preserving approach, with the incisions hidden beneath the breast and a well-proportioned reconstruction, makes mastectomy even more acceptable to more women."
Nevertheless, experts said, if women do opt for NSM, it's important to have a surgeon who is well-versed in the surgery and has performed it many times, as risks include infection, not adequately taking out the cancerous tissue and potential nipple loss because the blood supply could get cut off.
Lichtenfeld noted that, after being informed of her options, every woman must make her own personal decision for breast cancer treatment. Still, he expressed concern that some women may not know all their options, and they may be impacted by other patients' decisions to go a more aggressive route than necessary.
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