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10 years Experience with Nipple Sparing Mastectomy: A retrospective review and description of technical refinements at Cleveland Clinic

Korn, JM, Djohan R, Ozturk C, Hiuser A, Crowe J
Cleveland Clinic
2012-02-14

Presenter: Jason Korn

Affidavit:

Director Name: Steven Bernard

Author Category: Chief Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)

How does this presentation meet the established conference educational objectives?
This presentation will influence and aid in the treatment of breast cancer patients in the area.

How will your presentation be used by practicing physicians in the audience?
This presentation will educate practicing physicians, both community and academic, about the technical refinements of nipple sparing mastectomy and reconstruction. With this presentation we hope that the surgeons in the audience would be comfortable performing this procedure in their own practices.

BACKGROUND
The surgical management of breast cancer has continued to evolve since the Halsted radical mastectomy in the 1890s. The most recent advance of the mastectomy is the nipple sparring mastectomy (NSM) a natural progression from surgeons experience with skin sparing mastectomy. NSM offers the advantage of achieving an aesthetically pleasing reconstruction through preservation of the nipple areola complex with little disfiguration of the breast. Questions regarding the oncologic safety and feasibility of NSM remain and continue to be debated in the literature. Despite this, the use of nipple sparing mastectomy is increasing given mounting evidence of its safety.

METHODS:
We performed a retrospective review of our experience of NSM over the past 10 years at the Cleveland Clinic. Our analysis focused on the technical refinements of both the oncologic and reconstructive aspects of the procedure as well as the inclusion and exclusion criteria for potential candidates of NSM.

RESULTS:
Over 200 NSM mastectomies were performed at Cleveland Clinic since the initial procedure in September, 2001. A trend toward increasing use of NSM and oncologic safety is apparent.

CONCLUSION:
NSM is an oncologically safe and viable option in the appropriately selected patient resulting in aesthetically superior outcomes. The practice of NSM continues to increase at Cleveland Clinic allowing for refinement in our technique and patient selection.

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