Nipple sparing mastectomy is the surgical removal of the breast without removing any of the skin of the nipple and the dark skin around it which is called the areola. Breast cancer is the most common non-skin form of cancer in the United States, with 230,000 new cases diagnosed each year. Of this number, more than 100,000 women in the U.S. undergo mastectomies as a part of their breast cancer treatment and over 90% of those then go on to have their breast reconstructed. In more recent year’s breast removal has become a much more sophisticated process and surgeons and doctors are more aware of reducing the psychological consequences for a woman about to lose her breast and how she feels thereafter. As a result of this there are now procedures to surgically reconstruct the breast and also keeping the nipple, through the mastectomy process. The number of women who request breast reconstruction surgery after their mastectomy has grown from 10% in the 1980’s to about 90% in current times.
There are other benefits of the procedure as well as cosmetic, as it also increases confidence and self esteem in the women involved. A healthy mind and a healthy body come as a package and so this tends to improve overall health. The nipple can also still feel sensations, up to 60% of women have confirmed that they still feel sensations in the nipple after their nipple sparing mastectomy. No surgeon would ever be able to reconstruct sensation in a constructed breast and or nipple.
As always technology is progressing and at the beginning of 2018 a French woman Elodie Trouche underwent a double nipple sparing mastectomy, what is unusual about this you may ask. Well this one was performed by a robot at Long Island Jewish Medical Center in New Hyde Park, NY. Elodie Trouche who tested positive for the BRCA gene, but was not actually suffering from cancer, felt extremely empowered by the whole experience and the choices which she was able to make throughout this process.
The BRCA genes are human genes that produce proteins and whose purpose are to prepare damaged genes and produce tumor supressing proteins. When either of these genes becomes mutated then the cells can alter genetically, and this can lead to cancer. Some versions of the BRCA gene are inherited and this significantly increases the risk of developing cancers especially ovarian or breast cancers, specifically at younger ages than the average population.
The gene can be inherited from your mother or father and each child of a parent who carries the mutation has a one in two chance of inheriting it.
Ms Trouche was tested after her sister tested positive for breast cancer and the BRCA gene. After living through the trauma of the surgery and loss of identity felt by her sister, as well as her physical pain, the ordeal encouraged Ms Trouche to seek her solution. She remained focused and in control and as the surgery was a preventative measure she was less fearful, Ms Trouche believes that through education, progress and freedom of choice we can march forward and take some control when faced with this awful disease and the choices that follow.