Nipple-sparing mastectomy--is it worth the risk?

Nipple-sparing mastectomy (NSM) is a surgical protocol designed to reduce the disabling psychological effects of radical or skin-sparing mastectomy. The preservation of the nipple-areola complex produces a more-natural result of the breast reconstruction, but this preservation is suspected of increasing tumor local recurrence. To reduce this risk, different approaches have been proposed: restrict the inclusion criteria and/or add localized radiation therapy.

Technical tricks to improve the cosmetic results of breast-conserving treatment.

The paper describes different manoeuvres and surgical details that may help the general surgeon to improve the aesthetic outcomes after breast-conserving treatment for cancer. Among them, the pre-operative planning, the position of the patient in the operative room, the mobilisation of the glandular tissue when the tumour has been removed. All these manoeuvres contribute to achieving better symmetry with the healthy breast and to improve the final aesthetic result, minimising the surgical conflict between large resections and defects for optimal control of local disease and the consequent breast deformities.

Comparative study of surgical margins in oncoplastic surgery and quadrantectomy in breast cancer.

Background: Oncoplastic surgery for breast cancer is a novel concept that combines a plastic surgical procedure with breast-conserving treatment to improve the final cosmetic results. The aim of this study was to evaluate the oncological safety of oncoplastic procedures by studying the status of the surgical margins of the excised tumor specimen in comparison with standard quadrantectomies.

Methods: Thirty consecutive breast cancer patients undergoing oncoplastic surgery (group 1) and 30 patients undergoing standard quadrantectomy (group 2) were prospectively studied with regard to the stage of breast cancer, the surgical procedures performed, the volume of breast tissue excised, and the histopathology of the tumor specimen, with specific details on surgical margins.

The "perfusion map" of the unipedicled TRAM flap to reduce postoperative partial necrosis.

The unipedicled transverse rectus abdominis musculocutaneous (TRAM) flap is a well-known technique for breast reconstruction. However, it is clinically difficult to evaluate the blood perfusion of the flap in the operating room. A new technique of blood supply evaluation, employing indocyanine green dye (ICG) fluorescence videoangiography has been performed in 10 cases of unipedicled TRAM flap breast reconstruction.