Background: The history of surgical treatment of breast cancer is rich with contributions from many surgeons over the centuries. Among the recent advances in technique is the nipple-sparing mastectomy, which reflects the emerging focus on cosmetic outcomes.
Methods: We took a backward glance at the literature illustrating the evolution of surgical management of breast cancer, culminating with nipple-sparing mastectomy. The growing clinical data with nipple-sparing mastectomy are explored.
Results: The demand for nipple-sparing mastectomy has been steadily increasing at many institutions. Based on the clinical data reported, nipple-sparing mastectomy is an oncologically safe procedure for selected women who have or are at high risk for breast cancer.
Conclusions: For women facing mastectomy and their surgeons, the optimal aesthetic result centers on preservation of the nipple. However, nipple-sparing mastectomy is technically challenging, with long-term safety not yet confirmed. Evidence-based data are needed to document local tumor recurrence, distant metastasis, cosmetic outcomes, patient satisfaction, and procedural complications.