Skip to main content
SpringerLink
Log in

Nipple-Sparing Mastectomy with Electron Intraoperative Radiotherapy

  • Chapter
  • First Online:
Oncoplastic and Reconstructive Breast Surgery

  • 2726 Accesses

Abstract

Nipple-sparing mastectomy (NSM) with Electron intraoperative radiotherapy does not show any difference in the local recurrence, survival and distant metastasis rates from skin-sparing mastectomy. Our experiences show NSM with immediate breast reconstruction improves the final cosmetic and psychological outcomes. Preoperative tumour histology and imaging along with intraoperative retroareolar tissue examination should be considered to select a suitable candidate for NSM. The preventive role of intraoperative radiotherapy has not been demonstrated, although we argue in favour of it. Soon, the final decision to perform NSM will be based on the detailed histological, biological and molecular phenotype characteristics of the tumour and patient.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M et al (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347:1233–1241

    Article  PubMed  Google Scholar 

  2. Veronesi U, Saccozzi R, Del Vecchio M, Banfi A, Clemente C et al (1981) Comparing radical mastectomy with quadrantectomy, axillary dissection, and radiotherapy in patients with small cancers of the breast. N Engl J Med 305:6–11

    Article  PubMed  CAS  Google Scholar 

  3. Miller BT, Abbott AM, Tuttle TM (2011) The influence of preoperative MRI on breast cancer treatment. Ann Surg Oncol 19(2):536–540

    Article  PubMed  Google Scholar 

  4. Maxwell GP, Storm-Dickerson T, Whitworth P, Rubano C, Gabriel A (2011) Advances in nipple-sparing mastectomy: oncological safety and incision selection. Aesthet Surg J 31:310–319

    Article  PubMed  Google Scholar 

  5. Wellisch DK, Schain WS, Noone RB, Little JW 3rd (1987) The psychological contribution of nipple addition in breast reconstruction. Plast Reconstr Surg 80:699–704

    Article  PubMed  CAS  Google Scholar 

  6. Atisha D, Alderman AK, Lowery JC, Kuhn LE, Davis J et al (2008) Prospective analysis of long-term psychosocial outcomes in breast reconstruction: two-year postoperative results from the Michigan breast reconstruction outcomes study. Ann Surg 247:1019–1028

    Article  PubMed  Google Scholar 

  7. Schain WS, Wellisch DK, Pasnau RO, Landsverk J (1985) The sooner the better: a study of psychological factors in women undergoing immediate versus delayed breast reconstruction. Am J Psychiatry 142:40–46

    PubMed  CAS  Google Scholar 

  8. Didier F, Radice D, Gandini S, Bedolis R, Rotmensz N et al (2009) Does nipple preservation in mastectomy improve satisfaction with cosmetic results, psychological adjustment, body image and sexuality? Breast Cancer Res Treat 118:623–633

    Article  PubMed  CAS  Google Scholar 

  9. Djohan R, Gage E, Gatherwright J, Pavri S, Firouz J et al (2010) Patient satisfaction following nipple-sparing mastectomy and immediate breast reconstruction: an 8-year outcome study. Plast Reconstr Surg 125:818–829

    Article  PubMed  CAS  Google Scholar 

  10. Yueh JH, Houlihan MJ, Slavin SA, Lee BT, Pories SE et al (2009) Nipple-sparing mastectomy: evaluation of patient satisfaction, aesthetic results, and sensation. Ann Plast Surg 62:586–590

    Article  PubMed  CAS  Google Scholar 

  11. Petit JY, Veronesi U, Orecchia R, Rey P, Martella S et al (2009) Nipple sparing mastectomy with nipple areola intraoperative radiotherapy: one thousand and one cases of a five years experience at the European Institute of Oncology of Milan (EIO). Breast Cancer Res Treat 117:333–338

    Article  PubMed  CAS  Google Scholar 

  12. Algaithy ZK, Petit JY, Lohsiriwat V, Maisonneuve P, Rey PC et al (2011) Nipple sparing mastectomy: can we predict the factors predisposing to necrosis? Eur J Surg Oncol 38(2):125–129

    Article  PubMed  Google Scholar 

  13. Petit JY, Veronesi U, Lohsiriwat V, Rey P, Curigliano G, et al (2011) Nipple-sparing mastectomy–is it worth the risk? Nat Rev Clin Oncol 8(12):742–747

    Article  PubMed  Google Scholar 

  14. Lohsiriwat V, Rojananin S, Bhothisuwan K (2004) Prediction of nipple areolar complex Involvement in breast cancer. Thai J Surg 25:71–78

    Google Scholar 

  15. Benediktsson KP, Perbeck L (2008) Survival in breast cancer after nipple-sparing subcutaneous mastectomy and immediate reconstruction with implants: a prospective trial with 13 years median follow-up in 216 patients. Eur J Surg Oncol 34:143–148

    Article  PubMed  CAS  Google Scholar 

  16. Govindarajulu S, Narreddy S, Shere MH, Ibrahim NB, Sahu AK et al (2006) Preoperative mammotome biopsy of ducts beneath the nipple areola complex. Eur J Surg Oncol 32:410–412

    Article  PubMed  CAS  Google Scholar 

  17. Palmieri B, Baitchev G, Grappolini S, Costa A, Benuzzi G (2005) Delayed nipple-sparing modified subcutaneous mastectomy: rationale and technique. Breast J 11:173–178

    Article  PubMed  Google Scholar 

  18. Spear SL, Rottman SJ, Seiboth LA, Hannan CM (2012) Breast reconstruction using a staged nipple-sparing mastectomy following mastopexy or reduction. Plast Reconstr Surg 129(3):572–581

    Article  PubMed  CAS  Google Scholar 

  19. Intra M, Orecchia R, Veronesi U (2004) Intraoperative radiotherapy: the debate continues. Lancet Oncol 5:340

    Article  PubMed  Google Scholar 

  20. Orecchia R, Ciocca M, Lazzari R, Garibaldi C, Leonardi MC et al (2003) Intraoperative radiation therapy with electrons (ELIOT) in early-stage breast cancer. Breast 12:483–490

    Article  PubMed  CAS  Google Scholar 

  21. Veronesi U, Gatti G, Luini A, Intra M, Orecchia R et al (2003) Intraoperative radiation therapy for breast cancer: technical notes. Breast J 9:106–112

    Article  PubMed  Google Scholar 

  22. Spear SL (2009) Oncoplastic surgery. Plast Reconstr Surg 124:993–994

    Article  PubMed  CAS  Google Scholar 

  23. Petit JY, Veronesi U, Luini A, Orecchia R, Rey PC et al (2005) When mastectomy becomes inevitable: the nipple-sparing approach. Breast 14:527–531

    Article  PubMed  CAS  Google Scholar 

  24. Petit JY, Veronesi U, Orecchia R, Rey P, Didier F et al (2003) The nipple-sparing mastectomy: early results of a feasibility study of a new application of perioperative radiotherapy (ELIOT) in the treatment of breast cancer when mastectomy is indicated. Tumori 89:288–291

    PubMed  Google Scholar 

  25. Boneti C, Yuen J, Santiago C, Diaz Z, Robertson Y, et al (2011) Oncologic safety of nipple skin-sparing or total skin-sparing mastectomies with immediate reconstruction. J Am Coll Surg 212:686–693; discussion 693–685

    Google Scholar 

  26. Gerber B, Krause A, Dieterich M, Kundt G, Reimer T (2009) The oncological safety of skin sparing mastectomy with conservation of the nipple-areola complex and autologous reconstruction: an extended follow-up study. Ann Surg 249:461–468

    Article  PubMed  Google Scholar 

  27. Petit JY, Veronesi U, Orecchia R, Curigliano G, Rey PC, et al (2012) Risk factors associated with recurrence after nipple-sparing mastectomy for invasive and intraepithelial neoplasia. Ann Oncol 23(8):2053–2058

    Google Scholar 

  28. Mosahebi A, Ramakrishnan V, Gittos M, Collier J (2007) Aesthetic outcome of different techniques of reconstruction following nipple-areola-preserving envelope mastectomy with immediate reconstruction. Plast Reconstr Surg 119:796–803

    Article  PubMed  CAS  Google Scholar 

  29. Mori H, Umeda T, Osanai T, Hata Y (2005) Esthetic evaluation of immediate breast reconstruction after nipple-sparing or skin-sparing mastectomy. Breast Cancer 12:299–303

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Plastic Surgery, European Institute of Oncology, Milan, Italy

    Jean Yves Petit

  2. Division of Plastic and Reconstructive Surgery, European Institute of Oncology, Milan, Italy

    Stefano Martella

  3. Faculty of Medicine, Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Visnu Lohsiriwat

Authors
  1. Jean Yves Petit
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stefano Martella
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Visnu Lohsiriwat
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jean Yves Petit .

Editor information

Editors and Affiliations

  1. , BreastUnit, Hospital Nossa Senhora das Gracas, Rua Padre Agostinho 913 ap 51, Curitiba, 80430050, Brazil

    Cicero Urban

  2. , Plastic and Reconstructive Division, European Institute of Oncology, Via Ripamonti, 435, Milan, 20100, Italy

    Mario Rietjens

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Italia

About this chapter

Cite this chapter

Petit, J.Y., Martella, S., Lohsiriwat, V. (2013). Nipple-Sparing Mastectomy with Electron Intraoperative Radiotherapy. In: Urban, C., Rietjens, M. (eds) Oncoplastic and Reconstructive Breast Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-2652-0_25

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2652-0_25

  • Published:

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2651-3

  • Online ISBN: 978-88-470-2652-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation