reola-Sparing Mastectomy: efining the Risks

s l f m a t i t t a c t p g m w d e g he recent development and popularity of skin-sparing astectomy (SSM) is a likely byproduct of high-quality utogenous tissue breast reconstruction. Numerous nonandomized series suggest that SSM does not add to the risk f local recurrence. Although there is still some skeptiism, SSM has become a standard part of the surgical aramentarium when dealing with small or in situ breast ancers requiring mastectomy and in prophylactic mastecomy in high-risk patients. Some have suggested that SSM lso compares favorably with standard mastectomy for ore advanced local breast cancer. Recently, areolaparing mastectomy (ASM) has been recommended for a imilar subset of patients in whom potential involvement y cancer of the nipple-areola complex is thought to be low r in patients undergoing prophylactic mastectomy. For SM, the assumption is that the areola does not contain landular tissue and can be treated the same as other breast kin. Because no large series exists to define the risks of reserving the areola, it seems appropriate to critically reiew our knowledge of the areola and thereby attempt to efine those patients in whom ASM might be appropriate. ome topics thought to be relevant to ASM are: