Department of Gynecology, Technische Universität München, Klinikumrechts der Isar, Ismaninger Strasse 22, Munich, Germany.
Breast J. 2011 May-Jun;17(3):296-9. doi: 10.1111/j.1524-4741.2011.01079.x. Epub 2011 Mar 31.
Ablative breast cancer surgery still includes the routine excision of the nipple-areola complex (NAC). Nipple-sparing mastectomy (NSM) removes the breast tissue leaving no or little retroareolar ductal tissue but preserves the entire skin of the breast and the NAC. There is some consensus that NSM might be an oncologically safe option for patients with small and peripherally located tumors and probably for high-risk patients with prophylactic mastectomy. Several studies demonstrated that NSM may be feasible even in patients with large centrally located tumors or multicentric invasive carcinoma. So far, no generally applicable indications for NSM have been defined because long-term data are still limited. However, from our review of the literature obtained from a MEDLINE search (2003-2009) we conclude that the range of indications for NSM needs not to be limited to small peripheral tumors or to prophylactic treatment.
保乳术仍然包括常规切除乳头乳晕复合体（NAC）。保留乳头的乳房切除术（NSM）切除乳房组织，不留下或仅留下少量乳晕后导管组织，但保留乳房的整个皮肤和 NAC。有一些共识认为，对于肿瘤较小且位于外周的患者，以及可能需要预防性乳房切除术的高危患者，NSM 可能是一种肿瘤学上安全的选择。几项研究表明，NSM 甚至在肿瘤较大且位于中央或多中心浸润性癌的患者中也可能可行。到目前为止，由于长期数据仍然有限，因此尚未确定 NSM 的一般适应证。但是，根据我们对从 MEDLINE 搜索（2003-2009 年）中获得的文献的综述，我们得出的结论是，NSM 的适应证范围不一定限于小的外周肿瘤或预防性治疗。
