A two-stage approach to immediate nipple sparing mastectomy in breast reconstruction

Introduction: Immediate Implant Based Breast Reconstruction (IIBR) is the commonest breast reconstruction in the UK. Radiotherapy can have detrimental effects on the success of IIBR and is standard practice for node positive patients. Nipple sparing (NS) IIBBR has become popular due to the better cosmetic outcome. We propose a staged approach to NSIIBR, with initial sentinel lymph node (SLNBx) and sub-areolar biopsies (SABx), prior to reconstruction. This provides more information to guide the consent process and decision-making.