ReviewSkin-sparing mastectomy
Section snippets
Oncologic safety
The aim of mastectomy for breast cancer and for cancer prophylaxis is to remove as much breast tissue as possible. The only difference between SSM and conventional non–skin-sparing (NSSM) should be that the skin envelope is preserved in the latter; the same amount of breast tissue should be removed. Skin-sparing mastectomy also entails excision of the biopsy scar, skin obviously involved by tumor or overlying a superficial tumor in order to reduce the risk of local recurrence [2]. If there is
Ductal carcinoma in situ and skin-sparing mastectomy
Total mastectomy (NSSM) for DCIS achieves cure rates approaching 98% (local recurrence rate of 1.4% and breast cancer–specific mortality of 0.59%) [23]. Additionally, no adjuvant therapy is required after such treatment. Therefore, SSM and immediate breast reconstruction would seem an ideal option for patients necessitating or requesting mastectomy and reconstruction for DCIS, provided clear margins are achieved. This was examined in detail by Rubio et al [24]. In that study 95 patients
Preservation of the nipple-areola complex
The conventional SSM described earlier involves removal of the nipple-areola complex. This has a significant impact on the overall cosmetic effect of the breast reconstruction. The nipple-areola complex is removed because of the belief that the nipple-areola complex and its adjacent ducts may also harbour tumor cells that have spread distally along the ducts from the primary tumor. This belief was based on older studies that had demonstrated occult tumor in the region of the nipple-areola
Radiotherapy and skin-sparing mastectomy
The majority of women undergoing mastectomy do not require postoperative radiotherapy. However, patients with at least four positive regional lymph nodes or large (>5 cm) tumors are offered such treatment because it reduces the incidence of locoregional recurrence and improves survival [31]. Consequently, radiotherapy is indicated in some women who have undergone SSM and immediate breast reconstruction. Postmastectomy radiotherapy is, however, associated with local complications, thus causing
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Cited by (106)
Patients’ satisfaction after immediate breast reconstruction: Comparison between five surgical techniques
2019, Annales de Chirurgie Plastique EsthetiquePostoperative course after immediate breast reconstruction: Comparison between five surgical techniques
2019, Annales de Chirurgie Plastique EsthetiqueOncologic safety of skin-sparing mastectomy followed by immediate reconstruction in young patients with breast cancer
2019, Asian Journal of SurgeryCitation Excerpt :After adjusting for stage, there were no statistically significant differences between the two groups with respect to DMFS and BCSS at each stage. Several meta-analyses have concluded that SSM with reconstruction is an oncologically safe procedure, at least for patients with early-stage disease and a small tumor.26,27 However, comparable results have also been obtained for patients with stage III disease.
The evolving role of pre-pectoral ADM-assisted implant-based immediate breast reconstruction following skin-sparing mastectomy
2018, American Journal of SurgeryEvolution of Operative Technique for Mastectomy
2018, Surgical Clinics of North America