AACS: Prophylactic mastectomy increasingly chosen option
as presented at the Scientific Meeting of the American Academy of Cosmetic Surgery
Deciding to have a mastectomy without actually having breast cancer is not necessarily a radical alternative, as it might appear to be, according to a study presented at AACS, held in January in New Orleans. An increasing number of high-risk women make the choice to have prophylactic mastectomy, many after testing positive for BRCA gene mutations.
Ziya Saylan, MD, of Istanbul Surgical Hospital, reported that between 2008 and 2013, seven patients underwent prophylactic mastectomy at his facility. Five were unilateral (71.4%) and two bilateral (28.6%). Patient satisfaction was very high overall, particularly with regard to the expected breast fullness, he reported. The complication rate was also low. Two patients (28.6%) had limited periareolar scar hypertrophy and only one (14.3%) requested revisional surgery for scar revision.
Although in three cases (42.9%) a late enlargement of the nipple-areolar complex (NAC) developed, none of the patients requested a formal revisional NAC reduction. There were five cases (71.4%) of nipple-sparing mastectomy (NSM) and two cases (28.6%) of skin-sparing mastectomy with nipple reconstruction. In all patients the areola and the nipple returned to preoperative levels of blood supply and sensitivity, Dr. Saylan reported.
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