Nipple-Sparing Mastectomy in Breast Cancer: Impact on Surgical Resection, Oncologic Safety, and Psychological Well-Being

Nipple-sparing mastectomy (NSM) is a surgical option to improve patient satisfaction with aesthetic outcome. It can be utilized to decrease body image disturbance by preserving the woman's skin and areolar complex. Data for cancer treatment and risk reduction in NSM shows the procedure is oncologically safe. Nipple-sparing mastectomy preserves the nipple to improve cosmetic appearance. Patient satisfaction is higher for NSM compared with traditional mastectomy. PubMed and Cochrane databases were searched from January 1, 2013, to December 22, 2019. The following search terms and keywords were used: nipple-sparing mastectomy, microvascular breast reconstruction, breast cancer, and nipple necrosis. Studies published in scientific journals that reported objective results (specific outcomes of skin flap and nipple-areola complex necrosis) were included. Nipple-sparing mastectomy should be discussed as a surgical option for women who meet the selection criteria to assist with psychological benefits related to body image. Research comparing levels of distress and body image disturbances in women undergoing NSM with traditional mastectomy would be helpful in addressing the psychological care of these women. Ongoing data collection needs to continue to validate that NSM is safe from a surgical and an oncologic standpoint.