Nipple–Areolar Complex Neurotization Following Nipple-sparing Mastectomy and Breast Reconstruction for Solitary Breast Neurofibroma

Abstract

Neurofibromatosis type 1 (NF1) is a rare clinical entity when associated with breast tumors. Women diagnosed with NF1 are 5 times more likely to develop breast cancer from a preexisting neurofibroma lesion. Previous studies have recommended earlier breast cancer screening starting at age 30 for NF1 patients. Morbidity associated with NF1 lesions include pain, paresthesia, and motor deficits, which contribute to a decreased quality of life. Although breast involvement is rare, the most common location of neurofibromas involving the breast is the nipple-areolar complex (NAC). Mastectomy incision type and management of the NAC have not been well studied in NF1 patients with NAC-sparing breast neurofibromas. The purpose of this case report is to describe a 23-year-old woman with a severe breast deformity diagnosed with NF1 who underwent nipple-sparing mastectomy with immediate latissimus flap reconstruction and nipple neurotization. Neurotization of the nipple may restore sensation in NF1 patients who undergo nipple-sparing mastectomy and immediate breast reconstruction for an NAC-sparing solitary breast neurofibroma. Collaboration between surgical oncology and plastic surgery should guide surgical decision-making to optimize patient treatment and satisfaction outcomes.