Doctor insights on:
Will I Be Able To Keep My Nipples During A Mastectomy
May or may not: Most commonly a mastectomy for breast cancer includes removal of the nipple and areola. There is a type of mastectomy called nipple sparing mastectomy. This procedure may not be appropriate for cancer treatment in many situations. You need to talk to your breast surgeon to see if your condition is suitable for this procedure. Not all surgeons do this procedure. ...Read moreSee 1 more doctor answer
No: When patients undergo standard mastectomy, the nipples are removed and cannot be reattached. A better option in select patients would be to undergo a nipple-sparing mastectomy, which allows for preservation of the nipple and areola during mastectomy without removing them. For patients who have had the nipple removed during mastectomy, nipple reconstruction is available. ...Read more
Usually: But recently not always .There are nipple sparing techniques that are being followed very closely by the surgical community. Patients have to meet very specific criteria to be candidates for nipple sparing mastectomies as the goal is to not leave any cancer behind as well as provide the best cosmetic result. ...Read more
Not always.: The nipple has a small amount of breast tissue and can develop a cancer rarely. To truly remove all the breast tissue, the nipple has to go. In the case with angelina, here surgery was prophylactic meaning there was not any cancer present, she had the surgery to reduce the risk. In that setting some of the plastic surgeons who do reconstruction surgery will request that the nipples be undisturbed. ...Read more
Yes withreservations: Nipple saving mastectomy is often done in brca 1 or2 (genetically positive) patients(before cancer diagnosis) or in any patients withdcis or small- less than approx. 2 cm cancers- all at least 2 cm away from areola margin , no extensive dcis, no blood vessel invasion, no skin-muscle invasion .... No clinically positive lymph nodes under arm.But bra -cup size-must be: a or b cup, or not ptotic c cup. ...Read more
Usually: The gold standard oncologic mastectomy still includes removal of all the glandular tissue including the nipple/areolar complex since the ducts insert into the tip of the nipple. Leaving the nipple thus means leaving a minimal amount of breast tissue. Nipple sparing mastectomies are being done on an investigational basis for small tumors away from the nipple understanding the above. ...Read more
In most cases: A nipple sparing mastectomy can be performed for most women. At the time of surgery, a biopsy will be done of the tissue just behind your nipple; if this shows cancer, then your doctor will remove the nipple. It is not a good idea for women with large tumors, those with inflammatory cancer and women with tumors close to or involving the skin. See a breast surgeon or surgical oncologist. ...Read more
In general yes: But so many types are involved , where nipple , will be saved , depending on the disease. Speak to your doctor. ...Read more
Total: Mastectomy would involve removal of entire breast mound including the nipple/areola. A subcutaneous mastectomy, done usually in men with gynecomastia, removes the breast tissue only and spares the nipple/areola. A modified radical mastectomy would involve total mastectomy plus removal of axillary lymph nodes. ...Read more
Bigger operation: Mastectomy involves removing as much breast tissue as possible, either removing the nipple & areola or, occasionally keeping them but scraping as much breast tissue out just underneath. Either of these approaches will disrupt the nerves to that area. With augmentation, no tissue is removed; depending on scar and implant location, it should have minimal effects on the nipple-areolar tissue. ...Read more
Please explain why is nipple sensation more often lost with bilateral mastectomy and not augmentation?
Different: The surgical fields and tissues involved are different in that the location and direction of nerves is not involved with implants usually. ...Read more
After nipple sparing mastectomy is it normal for nipple to get scabby and dark (i wouldn't say it is black)?
NotNormalButCommon: The challenge of nipple-sparing mastectomy is to remove as much tissue under the nipple without compromising its blood supply; what you are describing is a consequence of the latter. While it may be too early to tell, the nipple may end up ok. When this happens under my care, i advise applying neosporin every 4 hrs while awake--check w/your surgeon what they recommend. ...Read moreSee 1 more doctor answer
Yes: Many studies have been published demonstrating this option to be safe, both for treatment of breast cancer and prevention in women with brca mutations. No surgery will take the risk of subsequent breast cancer down to zero--there is always some breast tissue left behind, albeit microscopic. Therefore, it stands to reason that the more left behind, the higher the risk; yet, it remains quite low. ...Read moreSee 2 more doctor answers
Possibly: Nipple-sparing and skin-sparing mastectomies are possible for certain women with breast cancer. It's not for women with tumors greater than 3cm, tumors within 2cm of the nipple, or multiple tumors. It is still controversial among experts, as there aren't long-term studies showing it's as safe as a simple mastectomy. Talk to your breast surgeon and your oncologist at length before deciding. ...Read moreSee 1 more doctor answer
Success rate for mastectomy retaining flap and nipple no sentinel node invasion stage 1b measures 8mm, margins good except anterior 1.5mm? Must chemo?
Tumor genetics: You could request a recurrence score which is a genomic evaluation of tumor cell gene s. 2 common tests in U.S. Are oncotype DX and mammaprint. ...Read more
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