Article Abstract

Midclavicular to inframammary fold measurement, a method of evaluation for nipple sparing mastectomy

Authors: Kenneth L. Fan, Francis D. Graziano, Olivia Abbate, Troy A. Pittman, Shawna C. Willey


Background: Preoperative assessment is vital to properly select patients for nipple sparing mastectomies (NSM). The objective of this paper is to describe a novel method, measuring from mid-clavicle to inframammary fold (IMF), to determine tissue envelope characteristics when evaluating a patient for a single stage, IMF incision NSM.
Methods: The authors conducted a retrospective review of all IMF incision NSM between October 2010 to July 2016 that had IMF to mid-clavicle measurements. Patient characteristics, mastectomy weight, complications, and the association between measurement were analyzed.
Results: Of a total 36 patients, 67 breasts were included for analysis. Increasing IMF to midclavicular measurements were found to be significantly related to increasing breast weight (P<0.001). Breast weight was found to be significantly related to breast cup size (P<0.001). Lastly, analysis revealed that increasing IMF to mid-clavicle measurement approaching 34 cm was associated with increased odds of complications occurring (OR 1.55, P=0.002).
Conclusions: The authors demonstrated that midclavicular to IMF measurement approaching 34 cm had significantly increased complication rates, thus making this a potential tool for assessing tissue envelope characteristics in the evaluation for NSM. We propose 34 cm being a relative cut-off for single staged NSM.