• Cancer

    Mayo Clinic Minute: Nipple-sparing mastectomy, pre-pectoral reconstruction

As effective as a more invasive procedure, nipple-sparing mastectomy with immediate pre-pectoral reconstruction offers a woman a more natural appearance following breast cancer surgery.

Mayo Clinic already has the most experience in the country with this team procedure, and requests for it continue to grow.

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"We are able to achieve really wonderful cosmetic results with this procedure," says Dr. Amy  Degnim, a Mayo Clinic breast cancer surgeon.

The first phase of this team procedure is nipple-sparing mastectomy to remove cancerous breast tissue, but, if possible, save all the skin, including the nipple and areola skin.

"So that after a reconstruction the result looks as natural as possible," explains Dr. Degnim. "Because it is the woman’s own natural skin that’s covering the reconstruction."

The natural look is furthered during the second phase of the surgery – an immediate pre-pectoral breast reconstruction.

"Once we know that negative margins – or clear margins – have been obtained, then I’m called into the operating room," says Dr. Valerie Lemaine, a Mayo Clinic plastic surgeon.

Unlike a traditional reconstruction that places the breast implant behind the chest muscle, in a pre-pectoral procedure, the implant goes in front of the muscle.

"The main advantage is the implant is positioned where the breast used to be anatomically," explains Dr. Lemaine.

Dr. Lemaine says another important benefit is patients report less pain in recovery, since the surgery is done without manipulating a muscle.

Research shows the nipple-sparing surgery is a safe choice for women with BRCA mutations being offered preventative mastectomy. Findings from a Mayo Clinic study on the issue have been published in JAMA Surgery.

"We want women to know that this is an option for many of them," adds Dr. Degnim.

Read more about breast cancer treatment at Mayo Clinic.