A skin sparing mastectomy is a breast removal procedure which leaves the skin encasing the breast intact, allowing for a breast reconstruction that is as natural as possible in appearance. It is generally performed on women who have breast cancer or who have a high risk of developing breast cancer as determined by personal and family history. During a skin sparing mastectomy, the breast tissue is taken out through a small opening made by the removal of the nipple and areola. Usually, the breast is then immediately reconstructed. Patients who may have cancer of the breast skin or who do not wish to have immediate breast reconstruction may be ineligible for a skin sparing mastectomy.
Women generally have mastectomies either because they currently have breast cancer or they have a high risk of developing breast cancer. A woman is generally considered to have an elevated risk of breast cancer if she has a personal or close family history of the disease, or if she has tested positive for the BRCA1 or BRCA2 genetic mutations, which are linked to an increased likelihood of breast cancer. Choosing a skin sparing mastectomy allows for the elimination of breast tissue which is or may become cancerous while leaving behind skin that can then be used in reconstructing the breast. This can result in a reconstructed breast that is natural in appearance, with minimal scarring.
The reason this kind of mastectomy is possible is because the skin which covers the breast is not actually part of the breast, and thus is generally not affected by cancer of the breast tissue. Both the areola and the nipple are part of the breast, however, and therefore the first step in the procedure is the removal of these parts. The breast tissue is taken out through the small opening made by the nipple and areola’s removal. A plastic surgeon then reconstructs the breast by filling the emptied skin with an implant or with tissue taken from another part of the patient’s body.
Certain circumstances may make a woman a poor candidate for a skin sparing mastectomy. First of all, this procedure is not recommended if there is a possibility that the skin cells surrounding the breast have become cancerous. It is also not suggested for women who do not wish to have their breasts reconstructed immediately, as the skin may begin to contract once the breast tissue has been removed. In these situations, removal of both the breast tissue and the surrounding skin may be advisable.
