Techniques and outcomes of nipple sparing mastectomy in the surgical management of breast cancer

Tailored therapy for breast cancer with conservation of uninvolved tissue is becoming increasingly important, especially as the benefits of breast reconstruction are recognized. Preservation of the nipple areolar complex during mastectomy is emerging as a viable option in selected patients. Technical considerations for prevention of adverse outcomes such as nipple necrosis are reviewed, along with implications for reconstructive method and outcomes. Finally, the oncologic efficacy of nipple-sparing mastectomy is discussed in the context of occult nipple disease and local recurrence. Standardization of technique, optimization of aesthetic outcome, and examination of long-term prognosis represent future areas of development.