Skin-sparing mastectomy is a procedure in which the breast is removed while leaving as much skin as possible for reconstruction.
Only the skin of the nipple, areola, and the original biopsy scar are removed, and the underlying breast tissue is then removed through the small opening this creates. The remaining pouch of skin provides the best shape and form to accommodate an implant or a reconstruction using one’s own tissue.
Many women choose this procedure in order to get the most realistic and pleasing results from breast reconstruction, which begins immediately upon completion of the mastectomy.
The new breast can be fashioned with the use of tissue expanders or with the patient’s own tissue. A new nipple and areola can also be made in a second procedure.
A sentinel node biopsy is usually performed in conjunction with a skin-sparing mastectomy, unless enlarged lymph nodes are present. If swollen lymph nodes are found together with cancer, then most of the lymph nodes will have to be removed.
“Assuming a patient is otherwise qualified to have one, when would a skin-sparing mastectomy NOT be performed?”
If breast reconstruction will not begin immediately upon completion of the mastectomy, then in most cases sufficient skin is removed to make the scar and the surface of the chest flat.
“Is there another instance in which a skin-sparing mastectomy would not be an option?”
The procedure would not be safe is there is a possibility that tumor cells are close to the skin, as in inflammatory breast cancer.