How Does a Nipple-Sparing Mastectomy Affect My Chances of Breast Cancer Recurrence?

Does a Nipple-Sparing Mastectomy Increase My Chances of Breast Cancer Recurrence?

Nipple-Sparing MastectomyWhen breast cancer patients consider undergoing a nipple-sparing mastectomy, the are often concerned about breast cancer recurrence.

They wonder, if this procedure leaves the nipple behind, is there a greater chance of cancer coming back?

According to Breast Cancer Answers Medical Director Dr. Jay Harness, there have been studies done of the ducts at the base of the nipple that study abnormal cancer cells as they arise.

The results of this study is very interesting. Watch Dr. Jay Harness in the video below to find out how nipple-sparing mastectomy affects you risk of breast cancer recurrence.


Dr. Jay Harness:  When I discuss with patients nipple sparing mastectomies, one of their concerns is, if we leave the nipple behind, am I going to have a greater chance of the cancer coming back.  Let me explain what the options are and the discussion around that subject.

If we leave the nipple and areolar area behind, is their a chance the cancer can come back at that side?  The answer of the question is yes, there is.  The number, however, is quite small, now what are the reasons for this, well not all of the ductal tissue of the breast is the same. 

As the ducts come up to and including inside the nipple, they lose the key component called the terminal ductal lobular unit, oh my goodness, TDLU, bit fancied term, but its in the TDLU, terminal ductal lobular unit, where we believe the first abnormal cancer cells arise. 

So, there has been good pathologic studies done of the ducts at the base of the nipple and inside the nipple that show the minimal chance that there will be TDLU’s within the nipple itself.  If you look at the world’s literature of the chance of the cancer coming back, either in the nipple or areola with very, very large studies, one of biggest studies in the world is from Milan, Italy with over an 800 of these. 

The chance of the cancer coming back on either the nipple or areola is well under 1%.  Now, even with a mastectomy, depending and forget whether we say the nipple or areola or not, there is a chance that a cancer can reoccur at the mastectomy site and over the lifetime of the patient, we tell them it is around 3 to 4% and again, this has to do with the biology of the cancer. 

So, the bottom line here is that the odds of the cancer coming back in the nipple areolar area is very small.  If it does come back, its easily found, easily noticed by the patient which all helps us feel lot better.  So, can it come back, yes, what are the odds of it coming back, really low.