Bladder urothelial carcinoma (BLCA) is the 10th most common cancer with a low survival rate and strong male bias. We studied the field cancerization in BLCA using multi-sample- and multi-tissue-per-patient protocol for sensitive detection of autosomal post-zygotic chromosomal alterations and loss of chromosome Y (LOY). We analysed 277 samples of histologically normal urothelium, 145 tumors and 63 blood samples from 52 males and 15 females, using the in-house adapted Mosaic Chromosomal Alterations (MoChA) pipeline. This approach allows identification of the early aberrations in urothelium from BLCA patients. Overall, 45% of patients exhibited at least one alteration in at least one normal urothelium sample. Recurrence analysis resulted in 16 hotspots composed of either gains and copy number neutral loss of heterozygosity (CN-LOH) or deletions and CN-LOH, encompassing well-known and new BLCA cancer driver genes. Conservative assessment of LOY showed 29%, 27% and 18% of LOY-cells in tumors, blood and normal urothelium, respectively. We provide a proof of principle that our approach can characterize the earliest alterations preconditioning normal urothelium to BLCA development. Frequent LOY in blood and urothelium-derived tissues suggest its involvement in BLCA.

Nipple-sparing mastectomy (NSM) with immediate implant-based breast reconstruction (IBBR) optimizes aesthetic outcomes, yet transection of intercostal sensory nerves commonly results in persistent nipple-areolar complex (NAC) anesthesia and, in some patients, denervation-related symptoms. NAC neurotization has emerged as an intraoperative strategy intended to improve protective sensation and potentially erogenous sensation by reconnecting donor intercostal nerves to the retroareolar plexus or to targets within the nipple. Here, we provide an anatomy-first narrative synthesis of the medial and lateral sensory corridors, with emphasis on the lateral cutaneous branches of T3–T5 and the reported anatomical landmarks that facilitate donor identification during NSM. We then review the biological constraints governing regeneration across the long trajectories typical of IBBR, including evidence suggesting reduced performance of acellular nerve allografts with increasing gap length and the rationale for autologous nerve transfers. Technical approaches are organized by (i) donor selection and harvest depth, (ii) graft choice, and (iii) distal coaptation strategies ranging from subareolar stump coaptation to targeted NAC reinnervation and direct nipple neurotization techniques. We also summarize the current clinical evidence regarding sensory recovery kinetics, safety and complications, operative time and cost, and propose practical checkpoints for intraoperative decision-making and standardized postoperative assessment. Collectively, available data support NAC neurotization as a feasible adjunct to NSM-IBBR, while highlighting the need for harmonized outcome reporting and longer follow-up to define comparative effectiveness among techniques.