Extended (> 3 cm in diameter) or multifocal ductal carcinoma in-Situ (DCIS) have an indication for mastectomy. During the past 30 years, surgical techniques for the treatment of breast cancer have significantly evolved, with advances in conservative and reconstructive techniques. Novel techniques like skin-sparing mastectomy (SSM) and nipple-sparring mastectomy (NSM) have gained a wider acceptance over radical mastectomy and modified radical mastectomy. The principles of the NSM are based on the preservation of both the nipple-areola-complex (NAC) and the breast natural skin envelope. The goals...

Patient population: This single-center prospective study was approved by the institutional review board (IRB) and patients’ consents were obtained for all patients. Between May 2011 and October 2014, all the consecutive patients admitted in our center for multifocal or larger than 3 cm DCIS, and therefore candidates for a mastectomy, were enrolled in the Carcinome In-Situ et Plaque Aréolo-Mamelonnaire (CISPAM) protocol (age 33-70, mean 50.1). The mean follow up after surgery was 40.3 months (quartiles 25-75%: 31- 47 months). CISPAM protocol: The inclusion criteria in...

Demographic characteristics: Seventeen mastectomies were performed in 17 patients. Eight left-sided mastectomies and nine right-sided mastectomies were performed. Ten (59 %) patients were treated with SSM and seven (41 %) with NSM. None of the planned NSM procedures were converted to SSM. Histopathological results: Fourteen (82 %) patients had grade 2 (intermediate grade), 2 (12 %) grade 3 (high grade) and 3 (18 %) patient had grade 1 (low grade) DCIS (Table 2). Tumor characteristics and NAC involvement are shown in Table 1. The NAC...

This prospective study suggests that NSM could be safely performed in patients with multifocal or extended DCIS and MRI-assessed TND ≥ 1 cm (despite prior studies stating a cut-off of 2 cm), with a low recurrence rate. In fact, no recurrent local disease has been observed during a mean follow-up of 40.3 months. 3T MRI with a high resolution protocol has a fair sensibility and specificity for the diagnosis of extension of DCIS to the NAC, with a good correlation to pathology. These results must...

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