Nipple-Sparing Mastectomy in the Community Setting

The majority of the surgical literature describing institutional experience with nipple-sparing mastectomy (NSM) has come from academic institutions. Little has been published by community-based surgeons who are responsible for more than 80 % of breast cancer surgical treatment in the United States. This chapter describes the experience of a single breast surgeon (JKH) over the past 11 years in the community setting as a member of a comprehensive multidisciplinary breast program. Early on, a more assertive approach was taken to include patients that others felt were not candidates for NSM. Overall, 374 areolar or nipple-areolar sparing mastectomies were performed in 237 patients. The loco-regional recurrence rates and complication profile were comparable to what is reported in the peer-reviewed literature. We hope that this will inspire other community programs to publish their experiences as a means of reinforcing the safety of NSM in the community setting.