Oncological and aesthetic considerations of skin-sparing mastectomy

Abstract

In appropriately selected cases SSM is oncologically adequate. There are several patient centred advantages over conventional mastectomy, including aesthetic outcome and the avoidance of multiple staged procedures. Despite widespread uptake into surgical practice, validation of these techniques from randomised controlled trials is lacking.

Immediate reconstruction with implants in women with invasive breast cancer does not affect oncological safety in a matched cohort study

“…These results have since then been corroborated by two review articles, including a metaanalysis of nine non-randomized trials [27,36]. The strength of our study is the long follow-up time with a median of 11.5 years.…”

“…As there may be a considerable interval before recurrences occur, confirmation of these results requires a long-term follow-up. There is also a lack of studies in this area, especially in patients receiving neoadjuvant chemotherapy and postoperative radiotherapy [27]. Karolinska University Hospital has 20 years of experience of implant-based IBR and two previous studies showed low rates of local recurrences [28,29].…”

Immediate nipple-areola-sparing mastectomy reconstruction: An update on oncological and reconstruction techniques

“…The satisfactory results are due to a close collaboration with the oncological surgical ed the technique for benign diseases, however he did not report the procedure for oncological objectives or as a risk-reduction alternative [10,11] . Recently, there has been an increase in clinical experience studies of NSM for breast cancer prophylaxis or early cancer treatment, evidencing revived interest in this surgical procedure [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][33][34][35][36][37][38][39][40][41][42][43][44] . In fact, there is evidence that NSM provides aesthetic advantages, with reduced need for further surgery and NAC reconstruction [15,17,[20][21][22]29,[33][34][35][36][37][38][39]…”

Conservative mastectomy versus nipple-sparing mastectomy: preliminary considerations of oncological safety on 30 patients not receiving intra-operative radiotherapy

“…Skin-sparing mastectomy allows better breast shape after reconstruction, minimizes residual scarring, and reduces the area of skin necessary on myocutaneous flaps. It also reduces the need for contralateral breast surgery to achieve a symmetric outcome (7). Indications are multifocal and multicentric breast cancer not involving the skin; unicentric cancer unsuited to quadrantectomy for anatomic reasons or smallsize breast, extensive ductal intraepithelial neoplasia (DIN), local recurrence (LR) after previous breast-conserving treatment, and patients at high genetic risk of breast cancer who request breast ablation.…”