Abstract
Introduction: skin sparing mastectomy with immediate autologous breast reconstruction has a positive psychosocial and sexual effect, however postoperative radiotherapy could adversely affect its cosmetic results. Patients and methods: This study included 24 female breast cancer patients underwent skin sparing mastectomy with or without scarifying NAC and immediate reconstruction by autologous TRAM and latissimus dorsi myocutaneous flap. They received adjuvant chemotherapy followed by 3DCRT, we evaluated them for skin complications and cosmoses. Results: Faint erythema or dry desquamation detected in 16 patients (66.6%), while 8 patients (29.2%) had moderate to brisk erythema. Two patients (8.3%) had skin edema and one patient (4.2%) had telangiectasia. Two patients complained from moderate pain Fat necrosis within the flap detected only in one patient (4.2%). Twentytwo patients (83.3%) had acceptable cosmoses while 2 patients had unsatisfactory cosmetic results. Conclusion: Postoperative radiotherapy is safe with acceptable rate of complications and very good patients satisfactions after skin sparing mastectomy and immediate autologous breast reconstruction.
Highlights
Skin sparing mastectomy with immediate autologous breast reconstruction has a positive psycho-social and sexual effect, postoperative radiotherapy could adversely affect its cosmetic results
nipple-sparing mastectomy (NSM) do not affect locoregional control as 5 years local recurrence reported in 3% to 6% of patients similar to modified radical mastectomy [4], and it has promising cosmetic results [5] have significantly greater cosmetic satisfaction compared to sparing mastectomy (SSM) [6]
Postoperative radiation therapy can be delivered after skin sparing mastectomy with the same indication after modified radical mastectomy, If immediate breast reconstruction is decided, implant can be done more safely keeping autologous breast reconstruction later, autologous immediate breast reconstruction can be done with high skilled team [3]
Summary
Skin sparing mastectomy with immediate autologous breast reconstruction has a positive psycho-social and sexual effect, postoperative radiotherapy could adversely affect its cosmetic results. Breast reconstruction has a positive psycho-social and sexual effect in the management of breast cancer patients, and immediate breast reconstruction does not compromise its oncologic safety, with comparable local control rates, and no delays in the initiation of adjuvant therapy [1]. NSM do not affect locoregional control as 5 years local recurrence reported in 3% to 6% of patients similar to modified radical mastectomy [4], and it has promising cosmetic results [5] have significantly greater cosmetic satisfaction compared to SSM [6]. There is no standard for postoperative radiotherapy following SSM and NSM, it proved to improve local control and had acceptable cosmetic results [8]. Incidence of nipple necrosis after postoperative radiotherapy was 5%, which is comparable to rates with surgery alone as reported by some series [6]
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