Dr. Jessica Pastoriza is the first surgeon in the region to perform the minimally invasive approach, which places the incision away from the breast, with reconstruction performed in the same operation by Dr. Gary Rosenbaum, Chief of the Division of Plastic Surgery

October 28, 2026 – Mount Sinai Medical Center now offers endoscopic nipple-sparing mastectomy, a surgical approach that removes breast tissue through a small incision placed beside the breast, near the underarm, rather than across the breast itself. Jessica M. Pastoriza, MD, FACS, a fellowship-trained breast surgical oncologist at the Braman Comprehensive Cancer Center, is the first surgeon in South Florida to perform the procedure. She operates alongside Gary J. Rosenbaum, MD, Chief of the Division of Plastic Surgery at Mount Sinai, who performs the breast reconstruction during the same surgery.

“A woman facing a mastectomy is asking two questions at once. Will this take care of the cancer, and what will I look like afterward,” said Dr. Pastoriza. “The first answer does not change with this approach. I remove the same tissue to the same margins. What changes is the answer to the second one.”

In a conventional nipple-sparing mastectomy, the surgeon works through an incision made on the breast itself. The endoscopic approach uses a smaller incision placed to the side, with a surgical access device that allows a high-definition camera and specialized instruments to reach the breast tissue. The camera gives the surgeon magnified visualization of the tissue being removed. The surgeon remains at the patient’s bedside throughout, operating with handheld laparoscopic instruments.

The approach changes how the surgeon reaches the breast tissue. It does not change the extent of the cancer operation. The same tissue is removed as in a conventional mastectomy, and the same principles of oncologic safety apply.

Because the incision sits outside the breast, the skin of the breast and the nipple are preserved and the resulting scar falls where the natural contour of the body and most clothing conceal it. Reconstruction is performed in the same operation, so the patient undergoes a single procedure rather than a staged series.

“Successful breast reconstruction begins with preserving the integrity of the breast skin and nipple. Endoscopic mastectomy represents an important advancement because it allows us to minimize visible incisions while preserving the natural breast envelope,” said Dr. Rosenbaum. “It means a woman can have her mastectomy and reconstruction in a single operation. From a reconstructive standpoint, this offers an exciting opportunity to achieve a more natural-looking breast while minimizing visible scarring.”

Not every patient is a candidate. The approach is used therapeutically in patients with a breast cancer malignancy and no skin or nipple involvement, and as a risk-reducing procedure in patients with BRCA1, BRCA2 or other genetic mutations, those with a family history of breast cancer, and those undergoing contralateral mastectomy. Eligibility is determined case by case and determined during your consultation.

About one in eight women in the United States will be diagnosed with invasive breast cancer in her lifetime, according to the American Cancer Society.

A 2025 meta-analysis published in BJS Open found significantly greater patient-reported cosmetic satisfaction with the endoscopic approach and comparable oncological outcomes, along with a reduced risk of skin and nipple necrosis when the procedure is performed through a single incision.¹

“Being among the top 2 percent of hospitals in the nation is a record of outcomes, and that record is what lets us bring something new to patients responsibly,” said Gino R. Santorio, President and Chief Executive Officer of Mount Sinai Medical Center. “I am proud that women in South Florida can find this approach here first, close to home and close to the people who will carry them through it.”

For more information, please visit https://www.msmc.com/.