Prophylatic nipple-sparing mastectomy cancer risk?

I had trouble finding hard numbers for this question - only found general information. (See Aetna link below- prophylactic mastectomy - that summarizes what their literature search came up with. )

http://www.aetna.com/cpb/medical/data/200_299/0227...

I had a unilateral mastectomy (skin sparing) following a bc diagnosis with DIEP reconstruction and later a contralateral prophylactic ns mastectomy with sGAP reconstruction. I was in a somewhat similar situation -- genetic testing was uniformative negative but with family history of bc. Almost all my physicians told me that they would go with a prophylactic mastectomy if they were in my shoes. To me the ns gave better cosmetic result compared to skin sparing. (I traveled to NOLA for my mastectomy and ns sGAP reconstruction.)

It is almost certain that there will be no (or very, very little) feeling in the nipple- generally with mastectomy and any form of reconstruction you cannot count on retaining any feeling in any part of the reconstructed breast. (I do have quite a bit of feeling- but not in the nipple - and consider it a very lucky gift.) With microvascular reconstruction and experiences ps I think it is rare to have problems with the placement of the nipple (I don't know much about implant reconstruction.) If this is a concern with a microvascular reconstruction you could post the question to Dr. Sullivan - (thread requesting questions at the top the breast reconstruction forum). An experienced microvascular ps sometimes decides do a breast "lift" on the reconstruction during stage 2 to improve the appearance and raise the placement of the nipple.

I was told that if ns fails for some reason they can always turn the reconstruction into skin sparing. It any type of reconstruction NS success depends in large part on the skill of the bs who does the mastectomy so if you decide to go that route, in addition to deciding on a ps, you need to be sure the bs has lots of experience with ns.

http://www.diepflap.com/treatments/nipple-sparing-...

Another link that might be helpful discussing ns. Allen is another well know high volume microvascular surgeon.

jthorne, I found this slide show useful. It shows a number of the studies done to date with regards to nipple sparing. http://www.massmed.org/Continuing-Education-and-Ev...

But be warned about halfway through there's several slides showing pictures of an actual mastectomy. I wasn't expecting that and I'm squeamish I just scrolled quickly past.

I had nipple sparing on my prophy side and am quite pleased with the results. I think the skill and experience of the surgeon is important. My surgeon was the first in my area to do skin sparing/nipple sparing and has quite a bit of experience doing them.

Kendra

http://www.medpagetoday.com/HematologyOncology/Bre...

This study was just presented at the American Society of Breast Surgeons'(ASBS) 2015 annual meeting- ---about the safety of ns mastectomy.

Hi! I had a nipple-sparing bilateral prophylactic mastectomy 8 weeks ago. I'm very happy with the results and the surgeon says they have more blood flow now than they did prior to surgery. There is no feeling of course, but it's helped me emotionally to keep my own nipples. There's a lot to be said for that. Good luck!