Jun 05, 2010 - 3:53 pm
I am posting this because I realized that not every women out there realizes that just like there are different kinds of breast cancer there are also different kinds of mastectomies.
I was diagnosed with DCIS in December. My surgeon told me my options were lumpectomy with radiation or mastectomy where they would save the skin but remove the nipples. Neither option was particularly appealing so I decided to do my own research. That is when I discovered NSM and the reason my surgeon did not tell me about it was because she was not trained in the procedure and she was under the mistaken belief that it would put me at higher risk for recurrence. Had I listened I would have had more disfiguring surgery than necessary.
I think all surgeons should be required to tell you about ALL of your options whether they can offer them or not. So here's some brief info on NSM. Not every women is a good candidate for this type of MX. Your cancer cannot be too close to the nipple. For the best odds of success you really should be somewhat smaller breasted. In larger women it is extremely difficult to maintain blood supply to the nipple if it has a long way to travel. If you want to have NSM you absolutely need to find a very experienced surgeon which can sometimes be very difficult depending on where you live. Only experienced surgeons are able to perform this MX successfully therefore ensuring your rate of recurrence is the same as traditional MX. During NSM your BS will scrape the cells within the nipple during your surgery and biopsy them right then and there. If they detect ANY cancer cells they will remove your nipple. And there is still a chance after the surgery that the blood supply to the nipple could still die off and you could lose it. (Again, by selecting an experienced surgeon you greatly improve your odds of this not happening.) And, lastly, although you can still keep your nipples the vast majority of women will lose all sensation within the nipple.
So, all that being said, if you feel this is a surgical treatment plan you might be interested in I urge you to do some research and seek out second opinions. On breastcancer.org there are several threads discussing this procedure and where they are being performed. Feel free to contact me for more information. I think all BC patients should have access to as much information as possible regarding your options before making a decision regarding treatment. As I have learned, you can't always count on your doctor to do that.