Abstract

Abstract Background: Skin sparing mastectomy (SSM) and immediate breast reconstruction (IBR) with latissimus dorsi (LD) flap is a tailored surgical procedure for breast cancer patients. In this study the oncologic safety, morbidities, and aesthetic results of SSM and LD IBR, as regards to patient satisfaction, were assessed. Material and Methods: Between March 2000 and February 2011, single surgeon performed SSM and IBR for 145 patients. Eighty-five patients completed the patient satisfaction survey, and 65 patients with SSM and LD IBR were included. The patients were divided into 2 groups according to their degree of satisfaction, and a stratified analysis was performed. Results: The mean age of the patients was 48.4 years (range, 21–74), and the pathologic results were infiltrating ductal carcinoma (n=48, 73.8%), ductal carcinoma in situ (n=15, 23.1%), and others (n=2, 3.1%). After a mean follow-up of 34 months (range, 1.6−89.9) no local recurrence occurred, and there were no skin necrosis or LD flap loss. Donor site morbidities were seroma (n=8, 12.3%), scarring (n=8, 12.3%), and back pain (n=6, 9.2%). Fifty patients (76.9%) were satisfied with their surgical outcomes, and 40% reported their degree of satisfaction as excellent. Breast symmetry (P<0.001), nipple cosmesis (P<0.001), surgeon assessment (P<0.001), observer assessment (P<0.001), and visual difference of bilateral breasts (P=0.021) were factors that affected the highest patient satisfaction. Conclusion: The present study demonstrated that our SSM and LD IBR was oncologically safe, and was associated with low morbidity rates. LD flap per se, without a prosthetic implant, could sufficiently produce a high level of patient satisfaction. Accurate surgical techniuqes and careful consideration for breast symmetry and nipple cosmesis would be the key to meet the patient's expectations and enhanced quality of life. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-16-14.

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