Localization of Intercostal Perforating Vessels Reduces Wound Complications From Nipple Sparing Mastectomy

Nipple Sparing Mastectomy (NSM) has been increasingly utilized over the last ten years for risk-reducing surgery and surgical treatment for breast cancer. The oncologic safety has been well established in multiple studies in appropriately selected individuals. Additionally, rates of wound complications and risk factors for wound problems are well documented. The intercostal perforating vessels (IPV) have been demonstrated to provide a significant proportion of the blood supply to the nipple-areolar complex1-3. Thus, preservation of these vessels is essential to reducing ischemic necrosis of the nipple-areolar complex. We propose that localization of these vessels utilizing intra-operative ultrasound (US) will reduce ischemic necrosis complications of NSM.

Objectives

Demonstrate that US is an effective means of localizing the IPV intraoperatively.
Evaluate the frequency of IPV preservation with the use of US.
Measure rate and severity of ischemic necrosis when US is utilized to preserve IPV.
Compare observed rate with historical controls.