One breast cancer treatment choice that has gained some traction in terms of preventing cancer recurrence is the nipple-sparing mastectomy. What is a nipple-sparing mastectomy? How does it differ from a regular mastectomy? For many, getting invasive treatment for breast cancer is intimidating, whether dealing with stage two or three cancer, or attempting to prevent the cancer itself. No matter the case, understanding the options with this procedure is important. Making the right decision means determining the least amount of risk and best quality of life.
The research study
A new study by the Journal of the American College of Surgeons showed many important findings. The first was that most women who suffer from breast cancer are able to have this procedure, which eliminates the concern of many patients.
So, what makes this procedure unique? This procedure allows the nipple to remain in place. By contrast, a standard mastectomy takes the whole breast. This procedure had a limited population with recurrences after five years. The rate was around five percent. Compared with many other treatment options, that is quite low. At first, doctors were hesitant in deciding whether removing just the breast tissue was enough. However, with time, they learned this was just as safe. Still, more long-term follow-up is required for an even more accurate assessment.
What are some of the advantages?
Women often prefer this option because it has better cosmetic outcomes. The more natural outcome allows the patient to have implants over a tissue expander. This is more convenient and less costly. It also takes less time, since the inflatable breast plant option takes several months. When trying to eliminate cancer, the most important factor is the medical outcome. Since the study did not find any significant difference, it is up to the patient and her doctor to decide. There may be personal case differences where it is more important to do the full mastectomy.
Since starting the procedure a decade ago, researchers have found several important details. Initially, the scope of the study was small. Over time, doctors found that certain conditions make this procedure more difficult. These include cancerous involvement of the nipple and areola, locally advanced breast cancer involving the skin, inflammatory breast cancer, or sagging breasts. Avoiding providing the procedure on patients with these conditions have allowed a great success rate with the cosmetic side of the procedure. The procedure itself has also been perfected. When doctors initially performed the procedures, several mistakes were made. This included leaving breast tissue under the nipple. Radiation was done afterward.
That strategy was less effective than doing a biopsy on the rest of the breast. This ensured that cancer rates stayed lower. While there was the possibility of nipple necrosis, or a decay in the tissue, this was found to be minimal. More encouraging was that only a small percentage had localized recurrences near the breast tissue. None had issues with the nipple tissue. A scientific reason for this is that it is unusual for cancer to start in the nipple. It is more likely to start in the breast tissue. This is especially true for higher risk patients. As a result, this operation is a viable option.
Breast cancer has many treatment options. Chemotherapy and radiation are both taxing on the patient’s body. If cancer has not spread to other parts of the body, a mastectomy is an option. This procedure has been done for many years, gaining popularity in recent times. A mastectomy removes the entire breast, and is a popularly used option in cases where cancer has not spread to other parts of the body because it can isolate the source. There is a possibility of a reoccurrence or remaining cancer cells, but the risk is much lower. Traditional mastectomies may pose a lot of concerns for patients. Aside from physical consequences, many patients may underestimate the effect that a mastectomy can have on self-esteem. Encouraging positive attitude and self-esteem is essential to fighting cancer through each step of the way.
Should you consider a nipple-sparing mastectomy?
When considering any medical procedure, you should weigh all the pros and cons. Choosing to get a nipple-sparing mastectomy is not an easy decision. There are a few disadvantages to this procedure. First, it can dull the feeling in the nipple. Some estimates put the dulling sensation at thirty to sixty percent. The procedure itself is best for candidates with smaller and more localized tumors.
From a cosmetic standpoint, there are also challenges. As stated earlier, this procedure is less effective on those with large or sagging breasts. Removing the tissue will change the look. More breast tissue, of course, makes the procedure more complex. The procedure overall is safe, but every individual case comes with risks, as with any other medical procedure. Blood supply to the nipple can be interrupted during the procedure. There is the possibility of losing the nipple if the blood supply is not adequate. Even if the nipple is not removed during surgery, there is the possibility of cancer later on. In that case, the nipple will have to be removed. Wound healing is another consideration. Younger women and those with good healing tendencies will heal faster. If you are older, the recovery for an invasive procedure may be intense. A condition like diabetes may also impede your ability to heal. Talk to your doctor to discuss what recovery time will look like.
An alternative option is a skin-sparing procedure. This procedure can save a lot of the skin. Like the nipple-sparing procedure, this procedure has cosmetic benefits. It has also been shown to be equally as effective as traditional mastectomies. Like the nipple-sparing procedure, this allows for a more natural look and is quicker for doctors to reshape the breast. Talk to your doctor about the advantages and disadvantages. You may want to compare the two procedures.
If you are considering this surgery, you may want to discuss it in detail with your doctor. Have them outline the benefits and risks of your case. Since everyone is different, you will want to ensure that you are a good candidate for this procedure. Understanding the prognosis and all the potential outcomes can help you determine if this procedure is the right option for you. Researching all the options before making the decision is crucial. There is also recovery time to account for. This type of surgery may involve some pain and may require bed rest. Involve family and friends in your recovery to help you. This will be useful when you are traveling for post operation appointments or resting at home. If cancer has spread or is not totally removed after surgery, you might have to consider other treatment options like chemotherapy.
U.S. FDA approves Puma Biotech's breast cancer treatment. (2017, July 17). Retrieved August 03, 2017, from http://www.reuters.com/article/us-puma-biotec-fda-idUSKBN1A2287