First in South Florida: Dr. Pastoriza’s Endoscopic Mastectomy

For women facing breast cancer or considering preventive surgery, the decisions surrounding treatment often involve more than medical outcomes alone. Patients also think about recovery, appearance, and maintaining a sense of normalcy. Mount Sinai Medical Center addresses those concerns by offering a new surgical option that combines oncologic excellence with an enhanced focus on quality of life.

Our medical center now offers endoscopic nipple-sparing mastectomy, an advanced procedure that removes breast tissue through a small incision placed near the underarm. Jessica M. Pastoriza, MD, FACS, DiplACLM, a fellowship-trained breast surgical oncologist at the Irma and Norman Braman Comprehensive Cancer Center, is the first surgeon in South Florida to perform the procedure. She works in collaboration with Gary J. Rosenbaum, MD, Chief of the Division of Plastic Surgery, who performs breast reconstruction during the same operation.

“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.”

Unlike a conventional nipple-sparing mastectomy, which requires an incision on the breast itself, the endoscopic approach uses a smaller entry-point positioned to the side of the breast. A high-definition camera and specialized instruments allow surgeons to precisely visualize and remove breast tissue while preserving the skin and nipple. Importantly, the approach does not change the extent of the cancer operation – the same amount of tissue is removed, and the same rigorous standards of safety apply.

Reconstruction is performed during the same operation, allowing patients to complete both procedures at once rather than undergoing multiple staged surgeries.

“Every incision made on the breast puts the skin and the nipple at risk, and that risk is what limits reconstruction,” said Dr. Rosenbaum. “Starting from the side protects the tissue I need most. It means a woman can have her mastectomy and her reconstruction in a single operation.”

Breast cancer remains one of the most common cancers affecting women, with the American Cancer Society estimating that 1 in 8 women in the United States will be diagnosed with invasive breast cancer during her lifetime. As treatment continues to evolve, innovations that improve the patient experience while maintaining excellent clinical outcomes are becoming increasingly important.

A 2025 meta-analysis published in BJS Open found that patients who underwent the endoscopic approach reported significantly greater cosmetic satisfaction while achieving comparable oncologic outcomes. The study also found a reduced risk of skin and nipple necrosis when the procedure was performed through a single incision.

As Mount Sinai continues to expand access to advanced cancer care, innovations like endoscopic nipple-sparing mastectomy reflect a commitment to treating the whole patient. To learn more about Mount Sinai’s Breast Center, click here.