Breast Cancer Molecular Subtypes and Chemotherapy Schedules Used in Neoadjuvant or Adjuvant Setting May Show Different Effects in Nipple-Sparing Mastectomy.

www.PRSJournal.com 495e Reply: The Effect of Neoadjuvant Chemotherapy Compared to Adjuvant Chemotherapy in Healing after Nipple-Sparing Mastectomy Sir: We would like to thank Dr. Altundag for his comments regarding our recently published study, “The Effect of Neoadjuvant Chemotherapy Compared to Adjuvant Chemotherapy in Healing after NippleSparing Mastectomy.”1 Nipple-sparing mastectomy places increased stress on the breast skin envelope, which can place patients at risk for ischemia-related complications such as mastectomy and nipple-areola complex necrosis, among other complications. Therefore, nipple-sparing mastectomy was initially offered routinely only to very carefully selected patients, usually undergoing mastectomy for prophylactic indications, because of both reconstructive and oncologic concerns. Nevertheless, as experience with nipplesparing mastectomy has grown, oncologic outcomes have been shown to approach those reached with traditional mastectomy techniques, such as skin-sparing mastectomy. Likewise, complication rates with nipplesparing mastectomy have been shown to be acceptably low. As such, nipple-sparing mastectomy is now being Letters