Skin-sparing mastectomy is a technique that preserves as much of the breast skin as possible. Skin-sparing mastectomy can be performed as a "simple" or "total" mastectomy or as a modified radical mastectomy to provide the skin needed for immediate reconstruction.
During skin-sparing mastectomy, the surgeon removes only the skin of the nipple, areola, and the original biopsy scar. Then the surgeon removes the breast tissue through the small opening that is created. The remaining pouch of skin provides the best shape and form to accommodate an implant or a reconstruction using your own tissue. Many women choose this type of mastectomy in order to get the most realistic and pleasing results from immediate breast reconstruction.
Most women are eligible for skin-sparing mastectomies. However, there are some exceptions:
- A skin-sparing mastectomy is not usually performed if you’ve decided that you will not have immediate breast reconstruction. If you won’t be having immediate breast reconstruction at the time of your mastectomy, your surgeon will most likely remove as much skin as is required to make your scar and the surface of your chest flat.
- A skin-sparing mastectomy is not safe if there is a possibility that tumor cells are close to the skin. If there's any question that the tumor may involve the skin, such as in inflammatory breast cancer, then skin-sparing mastectomy is not an option.
"A lot of people's first response is to give me all the decision-making responsibility. But they're happier when they feel they can make their own decisions. I usually say, 'Don't trust me, don't trust anybody. If what I say doesn't make sense, don't do it.' Most people are more satisfied with that. They feel better if they're more involved in making the decision that's best for them."-- Anne Rosenberg, M.D.