Nipple Sparing Mastectomy (NSM)

👉NSM is an oncologically sound option for selected breast cancer patients (as it is for prophylaxis) but there is no clear consensus as to the selection criteria.
👉Based on careful anatomic studies and recent comprehensive reviews, nipple involvement was present in 11.5% of reported NSM procedures, and was associated with:

  • Tumor-to-nipple distance of less than 2 cm
  • Positive nodes
  • Lymphovascular invasion
  • ER/PR-negative
  • HER2-positive
  • Locally advanced
  • Retroareolar tumors
  • Multicentric tumors

👉Local recurrence occurred more frequently in the skin flaps (4.2%) than in the nipple (0.9%).

👉Nipple necrosis was partial thickness in 6.3% and full thickness in 2.9% of patients.

👉A negative nipple margin is necessary for NSM but is not sufficient for patients whose tumors are otherwise unsuitable.

👉NSM is also not suitable for patients whose breasts are very large and/or ptotic, who are elderly, or who have significant comorbidities.


  1. Mallon P, Feron JG, Couturaud B, et al. The role of nipple-sparing mastectomy in breast cancer: a comprehensive review of the literature. Plast Reconstr Surg. 2013;131:969-984.
  2. Rusby JE, Brachtel EF, Michaelson JS, et al. Breast duct anatomy in the human nipple: three-dimensional patterns and clinical implications. Breast Cancer Res Treat. 2007;106:171-179.
  3. Rusby JE, Brachtel EF, Othus M, et al. Development and validation of a model predictive of occult nipple involvement in women undergoing mastectomy. Br J Surg. 2008;95:1356-1361.
  4. Rusby JE, Smith BL, Gui GP. Nipple-sparing mastectomy. Br J Surg. 2010;97:305-316.

👉Rodrigo Arrangoiz MS, MD, FACS cirujano oncology y cirujano de mamá de Sociedad QuirĂşrgica S.C en el America British Cowdray Medical Center en la ciudad de Mexico:

  • Es experto en el manejo del cáncer de mama.


👉Es miembro de la American Society of Breast Surgeons:


• General surgery:

• Michigan State University:

• 2004 al 2010

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• Fox Chase Cancer Center (Filadelfia):

• 2010 al 2012

• Masters in Science (Clinical research for health professionals):

• Drexel University (Filadelfia):

• 2010 al 2012

• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:

• IFHNOS / Memorial Sloan Kettering Cancer Center:

• 2014 al 2016











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