What is endoscopic nipple-sparing mastectomy? Ospedale del Mare in Naples is Campania's first center to adopt the Endoscopic nipple-sparing mastectomy (e-NSM) technique, a minimally invasive procedure that removes breast cancer tissue while preserving skin, areola, and nipple using endoscopic instruments. This intervention represents a significant qualitative leap in modern breast cancer surgery, offering patients a rarely encountered combination of oncological safety, superior aesthetic outcomes, and improved postoperative quality of life.
This innovative e-NSM procedure has been adopted and developed by the Senology Surgery Departmental Unit directed by Prof. Antonio Marano, a specialist with established expertise in breast oncological surgery. The e-NSM technique applies to breast cancer treatment in carefully selected patients and prophylactic mastectomy for women carrying genetic mutations (BRCA1/BRCA2) with elevated breast cancer risk. The procedure removes the entire breast gland while completely preserving skin, areola, and nipple through minimal endoscopic access points, followed by immediate reconstruction with prosthetic implants.
The strength of the approach at Ospedale del Mare lies in exemplary multidisciplinary integration: in collaboration with the Reconstructive Plastic Surgery Unit directed by Prof. Alfredo Borriello (Chief of Plastic Surgery with 35+ years of experience) and the Anesthesia and Intensive Care Unit directed by Dr. Ciro Fittipaldi, immediate breast reconstruction with implants is performed during a single hospital admission. This strategy allows patients to undergo one procedure instead of two, eliminating the need for a second hospitalization and providing significant psychological benefits.
Superior aesthetic outcome: nipple preservation provides cosmetic results significantly superior to conventional total mastectomies. Preserved sensation: the nipple maintains reduced but present sensation, crucial for body self-perception and sexual function. Accelerated recovery: minimal endoscopic access causes less tissue trauma, with hospital stays of only 3-4 days, return to daily activities in 2-3 weeks, and complete functional recovery in 4-6 weeks. In comparison, conventional total mastectomies typically require 6-8 weeks of recovery. Equivalent oncological safety: international studies demonstrate that e-NSM, performed with rigorous patient selection criteria, offers identical oncological outcomes compared to traditional mastectomies.
It is important to emphasize that e-NSM remains indicated only for carefully selected cases. Inclusion criteria include: absence of clinical and radiological involvement of the nipple-areola complex, tumor location at distance from the nipple complex, histological type not associated with high risk of nipple involvement, and patient willingness to undergo intensive surveillance. The procedure is particularly indicated in women with hereditary predisposition (BRCA mutation carriers) desiring prophylactic mastectomy, where the absence of nipple pathology enables optimal aesthetic preservation.
«The endoscopic nipple-sparing mastectomy e-NSM intervention - stated Dr. Maria Corvino, Medical Director of Ospedale del Mare - represents an important step forward in oncological breast surgery. This minimally invasive technique allows patients to simultaneously benefit from three crucial factors: faster recovery, superior aesthetic results, and minimizing the devastating psychological impact often characterizing the cancer care pathway. Ospedale del Mare is proud to offer all eligible patients this innovative therapeutic option, confirming our role as an excellence facility in the Campania region.»
«We are particularly proud - added Dr. Gaetano Gubitosa, General Director of Ospedale del Mare - to have introduced this cutting-edge procedure in our hospital, confirming our strategic commitment to offering patients the best therapeutic options available. Our multidisciplinary teams, composed of breast surgeons, plastic surgeons, anesthesiologists, and specialized nurses, work with constant dedication and high professionalism to ensure technical success and comprehensive patient well-being. The e-NSM represents tangible evidence of our commitment to responsible medical innovation and improvement of quality of life for patients with breast cancer pathology.»
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