Sukhotko AS, Bumbu A, Covantsev S. Preservation of the nipple-areolar complex during subcutaneous mastectomy: A surgical and diagnostic method. World J Clin Oncol 2025; 16(5): 104398 [DOI: 10.5306/wjco.v16.i5.104398]
Corresponding Author of This Article
Serghei Covantsev, MD, Department of Clinical Research and Development, Botkin Hospital, 2nd Botkin Ave, Moscow 125284, Russia. kovantsev.s.d@gmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Opinion Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. May 24, 2025; 16(5): 104398 Published online May 24, 2025. doi: 10.5306/wjco.v16.i5.104398
Preservation of the nipple-areolar complex during subcutaneous mastectomy: A surgical and diagnostic method
Anna S Sukhotko, Anna Bumbu, Serghei Covantsev
Anna S Sukhotko, Department of General Oncology, Botkin Hospital, Moscow 125284, Russia
Anna Bumbu, Department of Oncology, Botkin Hospital, Moscow 125284, Russia
Serghei Covantsev, Department of Clinical Research and Development, Botkin Hospital, Moscow 125284, Russia
Author contributions: Sukhotko AS and Covantsev S designed and directed the project; Sukhotko AS, Covantsev S, Bumbu A performed the procedures; Sukhotko AS and Bumbu A analysed the results; Sukhotko AS, Bumbu A and Covantsev S wrote the article. All authors have read and agree with the final version of the manuscript.
Conflict-of-interest statement: The authors declare that they do not have any conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Serghei Covantsev, MD, Department of Clinical Research and Development, Botkin Hospital, 2nd Botkin Ave, Moscow 125284, Russia. kovantsev.s.d@gmail.com
Received: December 20, 2024 Revised: March 11, 2025 Accepted: March 18, 2025 Published online: May 24, 2025 Processing time: 151 Days and 9.8 Hours
Abstract
Simultaneous oncological and reconstructive plastic surgery on the mammary gland in the treatment of cancer is currently one of the important stages in the psychological rehabilitation of patients. In order to achieve a good cosmetic result, reconstruction must be performed simultaneously with radical surgical treatment. Currently, there are a large number of methods for performing breast reconstruction. One of the most commonly used is radical subcutaneous/skin-sparing mastectomy with simultaneous reconstruction with a silicone endoprosthesis. Grand W Carlson type technique is used, with skin incisions in the form of an inverted T is usually performed in patients with large mammary gland with severe grade III ptosis, as the patients usually require reduction of excess skin. However, the most vulnerable aspects of this type of reconstruction is the impossibility of preserving the nipple-areolar complex (NAC), which is associated with a high risk of developing such complications as partial/complete necrosis of the NAC. The current study provides an overview of an original method to decrease the risk of necrosis of NAC with evaluation of blood supply of the nipple and inferior deepithelialized flap using real-time intraoperative Doppler ultrasonography and indocyanine green fluorescence system.
Core Tip: Simultaneous oncological and reconstructive plastic surgery on the mammary gland in the treatment of cancer is currently one of the important stages in the psychological rehabilitation of patients. Flap necrosis during oncoplastic surgery can compromise the procedure. Unfortunately, this is a frequent complication in oncoplastic surgery. Doppler ultrasonography imaging, indocyanine green imaging and cover of the breast implant with inferior mammary ligament can provide better outcomes in patients who undergo subcutaneous mastectomy for breast cancer.
