What is a Nerve Sparing Mastectomy

Dr. Anne Peled:

“Who is a candidate for Sensation Preserving Mastectomy?⁠
Sensation-preserving mastectomies can be offered to those who are diagnosed with breast cancer or those who are at high risk for future breast cancer and are considering prophylactic mastectomy.⁠

Sensation preservation at the time of mastectomy involves saving nerves when oncologically safe (meaning the nerves run in the fatty tissue layer beneath the skin) and/or reconstructing nerves that need to be cut during the mastectomy (meaning they run through the breast tissue and do not stay in the fatty tissue layer). Each person’s situation is unique, so an evaluation to determine if they are a candidate for sensation-preserving mastectomies, as well as if a nipple-sparing mastectomy is right for them and the best choice for their reconstruction, is key to coming up with a final surgical plan.⁠

Why is this procedure so critical and unique?⁠

While mastectomies can be extremely effective at reducing the risk of breast cancer, most women don’t realize that they will have little, if any, sensation in their breast skin or nipple skin afterwards. Because of the way the nerves to the breast skin and nipple travel through the breast tissue, traditional mastectomies tend to cut through these nerves, which leads to breast and nipple numbness for many women, or even sometimes painful sensations at the cut nerve ends. ⁠

Studies that have looked at sensation after traditional mastectomy consistently show that the majority of women do not ever regain even sensation to light touch throughout their breasts (let alone any pleasurable sensation). Because of the variable nerve anatomy in the breasts, there are some women who may get lucky and have sensation return over time without active preservation of nerves during surgery, but most women will not. With sensation-preserving mastectomy, women are given the opportunity to feel like themselves again after mastectomy without a constant reminder of their surgery as a result of chest numbness.⁠”⁠

Source: annepeledmd.com, Dr. Anne Peled