Oklahoma City-area breast cancer patients now have access to a mastectomy technique that uses a small incision tucked under the arm instead of a larger cut across the chest. OU Health says it is offering endoscopic nipple-sparing mastectomy at Stephenson Cancer Center, a procedure the hospital describes as the first of its kind available in the Oklahoma City metro.
The technique relies on specialized instruments and a small incision on the side of the chest to remove breast tissue while preserving the nipple and surrounding skin, according to KOKH. Dr. Omar Qutob, a breast cancer surgeon at OU Health Stephenson Cancer Center, said the procedure uses a very small incision, and the placement means it can be hidden by the patient's arm. Elsewhere, surgeons describe the mechanics similarly: the endoscopic approach uses a camera, its own light source and carbon dioxide to expand the tissue for better visibility during surgery, according to a separate report on a similar procedure performed at UMC El Paso, as described by KVIA.
That technique preserves the skin below the nipple and areola while removing only the breast gland underneath, per the same KVIA report. Surgeons there said the endoscopic approach can reduce scarring and help maintain a more natural breast appearance. Oklahoma City's version follows the same basic principle, with the incision placed where it is less visible day to day.
Who Qualifies, and Who Doesn't
OU Health says endoscopic nipple-sparing mastectomy may be an option for some patients undergoing mastectomy because of breast cancer, elevated cancer risk, or concerning lesions, though it is unsuitable for others. Patients with very large or sagging breasts may not qualify, and neither may patients whose cancers sit close to the skin or nipple, per KOKH's reporting. Eligible patients may also receive reconstruction during the same operation, through the same incision.
Nationally, eligibility hinges on similar factors. According to Stanford Medicine, whether a patient qualifies may depend on breast size and shape, nipple position, tumor size and the distance between the cancer and the nipple. The Cleveland Clinic notes that nipple-sparing mastectomy in general may not be recommended for people with advanced breast cancer that could invade the nipple, areola or skin, and that the primary risk is losing the nipple if blood flow isn't restored during healing. Surgeons may also switch to an open procedure mid-operation if necessary, OU Health notes.
What Patients Can Expect
OU Health patients undergoing the procedure typically go home the same day, mirroring a broader pattern: nipple-sparing mastectomy is usually outpatient surgery nationwide, the Cleveland Clinic reports, though some patients may stay overnight. The tradeoff can be time in the operating room — an endoscopic nipple-sparing mastectomy can take about 30 minutes longer than the conventional version, per the Cleveland Clinic.
OU Health reported that its first patients treated with the procedure in recent weeks were closely monitored and are doing well. The hospital frames the potential payoff in both physical and emotional terms. Dr. Ahmet Demir, an OU Health plastic and reconstructive surgeon, said scars are marks on the body and that the procedure can provide a better cosmetic result, describing a mastectomy as something like the loss of an organ. OU Health says the approach can affect how patients feel about their appearance after surgery, and that it may result in less pain, faster recovery and better nipple sensation for those who qualify.
Mixed Evidence From Other Hospitals
Oklahoma City is not alone in adopting the technique. UMC El Paso recently performed what KVIA described as its first endoscopic nipple-sparing mastectomy, and the outlet reported the hospital is among only a handful of clinics in the United States currently offering it. Boulder Community Health in Colorado began offering E-NSM in September, with surgeon Susan Hagen, MD, FACS, treating three women during the week of August 24–28, according to Boulder Community Health. BCH describes the approach as an alternative to conventional open nipple-sparing mastectomy that uses a small, discreet incision beside the breast, roughly 3 to 3.5 centimeters long. Stanford Medicine has reported that surgeon Dr. Jean Bao recently performed her first E-NSM case at Stanford Health Care in Emeryville.
The research record on outcomes is still developing and not entirely consistent. Boulder Community Health cites research suggesting the endoscopic approach may improve cosmetic outcomes, reduce postoperative pain and complications, and increase patient satisfaction. Stanford Medicine likewise points to potential benefits including a smaller incision, improved surgical visualization and a potentially easier recovery, and notes that early studies suggest the approach may be associated with fewer skin or nipple necrosis complications, though it cautions that additional evidence is needed. But a meta-analysis published in BJS Open found mixed results on one specific measure: one study reported significantly lower nipple sensation loss with the endoscopic approach, while another found no difference in sensory abnormalities or pain between endoscopic and conventional techniques.
OU Health and surgeons elsewhere emphasize that the procedure is not a fit for everyone, and hospitals including OU Health recommend patients discuss the potential benefits, risks and alternatives with their care team before deciding on surgery.
