336 Review Article Nipple-sparing mastectomy in women at high risk of developing breast cancer Rebecca S. Lewis1, Angela George2, Jennifer E. Rusby1 1Department of Breast Surgery, Royal Marsden NHS Foundation Trust and the Institute for Cancer Research, Sutton, UK; 2Department of Cancer Genetics, Institute for Cancer Research and the Royal Marsden NHS Foundation Trust, Sutton, UK Contributions: (I) Conception and design: RS Lewis, JE Rusby; (II) Administrative support: None; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: RS Lewis, A George, JE Rusby; (V) Data analysis and interpretation: A George, JE Rusby; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Jennifer E. Rusby. Department of Breast Surgery, Royal Marsden NHS Foundation Trust and the Institute for Cancer Research, Sutton, UK. Email:
[email protected]. Abstract: Nipple-sparing mastectomy is a valuable addition to the options available for women at high risk of developing breast cancer. In this review, we summarize current knowledge about the high-risk genes, BRCA1, BRCA2 and TP53 and the associated guidelines with regard to risk-reducing surgery. We consider other genetic risks and high-risk lesions. We discuss the literature on bilateral mastectomy for breast cancer risk-reduction, and the results of nipple-sparing mastectomy in particular. Finally, we report on patient satisfaction with these procedures and the impact that nipple-sparing mastectomy may have on women at high-risk of breast cancer. Keywords: Breast cancer; nipple-sparing mastectomy; high-risk Submitted Jan 21, 2018. Accepted for publication Mar 28, 2018.