Nipple Sparing Mastectomy Saves Lives and External Breast


Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, agreed that the procedure is a good one for some patients who qualify, but he also expressed worry over the seemingly growing trend for women undergoing extreme surgeries, such as mastectomies, when they may have lesser invasive surgical options for their breast cancer treattment.

"It appears that some of these women who could have less aggressive surgery are opting for mastectomies for their own reason," said Lichtenfeld, who began treating women with breast cancer in the 1970s. "The risk is that people who influence other people, celebrities or other people in the media, may make a pronouncement that might lead other women to get a mastectomy when they don't really need it."

His expressed concerns come on the heels of Wanda Sykes' announcement last month that she underwent a double mastectomy after doctors diagnosed her with DCIS in her left breast. The non-invasive breast cancer is usually treated with a lumpectomy and has an excellent prognosis when found early.

"I was very, very lucky because DCIS is basically stage-zero cancer," Sykes said on the "Ellen DeGeneres show in September. "So I was very lucky."

"There is some evidence that excellent reconstruction options is one reason more and more women are choosing bilateral mastectomy," said Dr. David Euhus, professor of surgical oncology at University of Texas Southwestern Medical Center. "The nipple-preserving approach, with the incisions hidden beneath the breast and a well-proportioned reconstruction, makes mastectomy even more acceptable to more women."

Nevertheless, experts said, if women do opt for NSM, it's important to have a surgeon who is well-versed in the surgery and has performed it many times, as risks include infection, not adequately taking out the cancerous tissue and potential nipple loss because the blood supply could get cut off.

Lichtenfeld noted that, after being informed of her options, every woman must make her own personal decision for breast cancer treatment. Still, he expressed concern that some women may not know all their options, and they may be impacted other women's decision to go a more aggressive route than necessary.

"What really scares me is that I went through the era where women were disfigured after mastectomies," said Licthenfeld. "Women were not as willing to come to the doctor if they felt a lump out of fear of disfigurement. I begin to wonder whether the prevalence and pronouncement of getting mastectomies will set us back, and women will be afraid that, if they feel a lump, they only have the option of mastectomy."

Nevertheless, "if woman makes an informed decision, then whatever she decides for a treatment option is acceptable," he said.

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