Long-term oncological results after 400 skin-sparing mastectomies

J Visc Surg. 2013 Nov;150(5):313-20. doi: 10.1016/j.jviscsurg.2013.09.011. Epub 2013 Oct 23.

Abstract

Objective of the study: Skin-sparing mastectomies (SSM) have gained acceptance among teams performing immediate breast reconstruction because this technique provides the best cosmetic outcome. Nevertheless, in France, concerns have been raised that limited skin excision during mastectomy could result in an increased risk of local recurrence especially in invasive breast cancer; many surgeons continue to have reservations regarding the oncologic safety of this operation. This is a retrospective, long-term follow-up study of 400 patients operated and followed by two oncoplastic surgeons.

Patients and methods: A total of 400 patients with breast cancer underwent SSM with immediate breast reconstruction from January 1, 1992 to December 31, 2002. The American Joint Committee on Cancer pathological staging was Stage 0 (41.5%), Stage I (33.25%), Stage II (16%), Stage III (7.5%), while 1.75% were non-stageable.

Results: With a mean follow-up period of 88 months (range: 13-215 months), the locoregional recurrence rate was 3.5%, the rate of distant metastases was 13.5%, and 83% of patients have remained free of recurrent disease.

Conclusion: This study provides encouraging results suggesting that skin-sparing mastectomy is a safe and reliable option for the management of selected cases of women with invasive or in situ breast cancer.

Keywords: Breast cancer; Recurrence risk; Skin-sparing mastectomy.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery*
  • Breast Neoplasms / therapy
  • Carcinoma in Situ / pathology
  • Carcinoma in Situ / surgery*
  • Carcinoma in Situ / therapy
  • Carcinoma, Ductal, Breast / pathology
  • Carcinoma, Ductal, Breast / surgery*
  • Carcinoma, Ductal, Breast / therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Mammaplasty* / methods
  • Mastectomy* / adverse effects
  • Mastectomy* / methods
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / etiology
  • Neoplasm Staging
  • Reoperation
  • Reproducibility of Results
  • Retrospective Studies
  • Surgical Flaps