JAMES JAKUB: This was a study of nine institutions, a large study of 348 women, 551 mastectomies. And in follow-up, none of them developed a breast cancer. So this is pretty exciting, because this operation is much more appealing to women, because it gives a much better appearance than the traditional mastectomy. And it seems to be a very safe way to offer a similar protection against breast cancer than the traditional mastectomy.

For patients who do not have the genetic mutation but feel they're at elevated risk of breast cancer because of family history and other reasons, then a nipple-sparing mastectomy is becoming much more accepted and much more commonly used, at least in the past decade. And it is shown to be safe, in terms of cancer prevention.

This is the largest study looking at patients who have the genetic mutation. And that's a different group, because they're really at significantly elevated risk. And every cell in their body has that gene mutation, so there is concern about leaving behind any breast tissue in those patients. And so there has been a tendency to want to be more aggressive with the risk-reducing operation in those patients. So I think this offers patients and providers a lot of reassurance that this appears to be a safe way to go.

I think the take-home message is a contemporary, a current nipple-sparing mastectomy, the way it's performed in the modern era, is a very effective and safe way to prevent or significantly reduce a woman's risk of getting a breast cancer, even in the group of patients who are highest risk, those who have a genetic mutation.