• G Houvenaeghel, M Cohen, M A Dammacco, F D'Halluin, C Regis, M Gutowski, O Acker, M Fournier, M Bannier, A Lusque, E Jouve, and MAPAMc trial group.
• Department of Surgical Oncology, Paoli Calmettes Institute and Centre de Recherche en Cancerérologie de Marseille (CRCM), Aix-Marseille University, Marseille, France.
• Br J Surg. 2021 Apr 5; 108 (3): 296-301.

BackgroundNipple-sparing mastectomy (NSM) with immediate breast reconstruction (IBR) is used increasingly when performing a prophylactic mastectomy. Few prospective studies have reported on complication rates. This complementary trial to the French prospective multicentre MAPAM trial aimed to evaluate the nipple-areola complex (NAC) necrosis rate in prophylactic NSM with IBR.MethodsPatient characteristics and surgical data were recorded. Morbidity after prophylactic NSM with a focus on NAC necrosis was analysed.ResultsAmong 59 women undergoing prophylactic NSM, 19 (32 per cent) of the incisions were partly on the NAC. Reconstructions were performed with 46 definitive implants and 13 expanders. The crude rate of postoperative complications was 25 per cent (15 patients). Complete NAC necrosis was reported in two women (3 per cent) and partial or total necrosis in nine (15 per cent). No NAC resection was necessary. Median BMI was lower in women with total or partial NAC necrosis compared with the others (20.0 versus 21.3 kg/m2 respectively; P = 0.034).ConclusionResults of this prospective study confirm that prophylactic NSM with IBR is associated with a low risk of total NAC necrosis.© The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please email: journals.permissions@oup.com.

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