Predictors of nipple ischemia after nipple sparing mastectomy

Grant W. Carlson, Kai-Cheng Chu, Hunter R. Moyer, Claire Duggal, Albert Losken

Research output: Contribution to journalArticle

30 Scopus citations


Nipple sparing mastectomy (NSM) has become an accepted approach in selected cases of breast cancer and prophylactic mastectomy. Various surgical techniques have been described and nipple ischemia has been a common complication. Potential risk factors for nipple ischemia after NSM are examined. To examine predisposing factors for nipple ischemia after NSM. Prospective evaluation of 71 consecutive NSM in 45 patients from 2009 to 2011 was performed. There were 40 mastectomies for cancer (56.3%), and 31 (43.7%) prophylactic mastectomies. In cases of cancer, the ducts were excised from the undersurface of the nipple. Reconstructive methods included: expander 58, latissimus flap/expander 2, implant 10, and free TRAM flap 1. Various patient and technical factors were examined for impact on nipple ischemia. Partial nipple necrosis occurred in 20 cases (28.2%). Nineteen cases healed uneventfully and one required secondary nipple reconstruction. Operations for cancer (OR 10.54, CI 1.88-59.04, p = 0.007) and periareolar incisions (OR 9.69, CI 1.57-59.77, p = 0.014) predisposed to nipple ischemia. Periareolar incisions and dissection of the nipple ducts for cancer have a higher risk of nipple necrosis after NSM.

Original languageEnglish (US)
Pages (from-to)69-73
Number of pages5
JournalBreast Journal
Issue number1
StatePublished - Jan 1 2014


  • ischemia
  • nipple sparing mastectomy

ASJC Scopus subject areas

  • Internal Medicine
  • Oncology
  • Surgery

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  • Cite this

    Carlson, G. W., Chu, K-C., Moyer, H. R., Duggal, C., & Losken, A. (2014). Predictors of nipple ischemia after nipple sparing mastectomy. Breast Journal, 20(1), 69-73.