Sparing mastectomy: what to know

In a skin-sparing mastectomy, most breast skin is kept while breast tissue and the nipple are removed. In a nipple-sparing operation, the nipple and areola may also be preserved when the tumour’s position and safety assessment allow it. The surgeon still removes the breast tissue, and the preserved skin is not the same as keeping the breast itself.

Reconstruction is often performed during the same operation or planned for a later stage. The choice may involve an implant or tissue from another part of the body. Suitability depends on tumour location, involvement of the skin or nipple, previous treatment, body factors, and the person’s preferences.

Ask the breast and reconstructive surgeons to explain which tissue can safely remain and where the incision will be. Discuss whether a lumpectomy could be appropriate, or whether a mastectomy is recommended for the disease pattern. If treatment before surgery is proposed, ask how chemotherapy before surgery could affect timing and the operation plan.

Before surgery, review reconstruction choices, drains, movement restrictions, scar care, sensation changes, and possible follow-up procedures. Removal or sampling of lymph nodes may be discussed separately. Arrange practical help for washing, dressing, meals, and transport while arm movement is limited.

Contact the surgical team urgently for rapidly increasing swelling, bright bleeding that does not settle, worsening redness or warmth, pus-like drainage, fever, severe pain, or a wound that opens. Sudden chest pain, severe breathlessness, fainting, or one-sided leg swelling needs emergency assessment. Numbness and tightness can occur during healing, but new or worsening changes should be reported.

Am I a candidate for skin-sparing or nipple-sparing surgery? Will the nipple or skin need testing during the operation? What reconstruction choices fit my treatment plan? How might radiotherapy affect reconstruction? What symptoms should prompt a call after discharge?