Skin-sparing mastectomy. Oncologic and reconstructive considerations
| Autor: | Douglas R. Murray, John Bostwick, Toncred M. Styblo, Jean Trimble Bried, William C. Wood, Bridgett Moore, Grant W. Carlson |
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| Rok vydání: | 1997 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent medicine.medical_treatment Mammaplasty Mammary gland Breast Neoplasms Breast cancer Postoperative Complications medicine Carcinoma Humans Total Mastectomy Mastectomy Aged Neoplasm Staging Retrospective Studies Aged 80 and over Skin sparing mastectomy integumentary system business.industry Retrospective cohort study Middle Aged medicine.disease Surgery medicine.anatomical_structure Female Neoplasm Recurrence Local business Breast reconstruction Follow-Up Studies Research Article |
| Zdroj: | Annals of surgery. 225(5) |
| ISSN: | 0003-4932 |
| Popis: | OBJECTIVE: The authors compared skin-sparing mastectomy and traditional mastectomy both followed by immediate reconstruction in the treatment of breast cancer. SUMMARY BACKGROUND DATA: Skin-sparing mastectomy is used increasingly in the treatment of breast cancer to improve the aesthetic results of immediate reconstruction. The oncologic and reconstructive outcomes of this procedure have never been analyzed closely. METHODS: Institutional experience with 435 consecutive patients who underwent total mastectomy and immediate reconstruction from January 1989 through December 1994 was examined. Mastectomies were stratified into skin-sparing (SSM) and non-skin-sparing (non-SSM) types. RESULTS: Three hundred twenty-seven SSMs and 188 non-SSMs were performed. The mean follow-up was 41.3 months (SSM, 37.5 months, non-SSM, 48.2 months). Local recurrences from invasive cancer occurred after 4.8% of SSMs versus 9.5% of non-SSMs. Sixty-five percent of patients who underwent SSMs had nothing performed on the opposite breast versus 45% in the group of patients who underwent non-SSM (p = 0.0002). Native skin flap necrosis occurred in 10.7% of patients who underwent SSMs versus 11.2% of patients who underwent non-SSMs. CONCLUSIONS: Skin-sparing mastectomy facilitates immediate breast reconstruction by reducing remedial surgery on the opposite breast. Native skin flap necrosis is not increased over that seen with non-SSM. Skin-sparing mastectomies can be used in the treatment of invasive cancer without compromising local control. |
| Databáze: | OpenAIRE |
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