Abstract
Background. Most women with breast cancer today can be managed with breast conservation; however, some women still require mastectomy for treatment of their disease. Skin-sparing mastectomy (SSM) with immediate reconstruction has emerged as a favorable option for many of these patients. The authors combined the SSM technique with the preservation of a small part of the areola with immediate nipple together with with breast reconstruction. Methods. In an 8-year-period 155 female patients (age: 20–52 years old; mean age: 37.5 years) with extensive ductal intraepithelial neoplasia (DIN) or invasive breast cancer were treated with areola skin sparing mastectomy with immediate nipple and breast reconstruction. Patients were followed up prospectively by the breast surgeon, the plastic surgeon, and the oncologist for complications and recurrence. Results. After treatment, only 2 cases (1.29%) had a local recurrence. 8 out of 155 (5.5%) patients developed early complications (infections, seroma, haematoma), and 5 out of 155 patients (3.22%) developed delayed complications (implant rotation, aestethic deterioration) in the post operative time period. The final aesthetic outcome was judged as positive in 150 out of 155 patients (96.78%). Conclusion. In our experience, immediate nipple reconstruction after skin-sparing mastectomy is a technically feasible procedure which can give excellent cosmetic results.
Highlights
Mastectomy represents the treatment of choice for approximately one-third of women with breast cancer due to aggressive, extensive, or multicentric tumour growth, contraindications for radiotherapy, or following the patient’s wish.To most of these cases, immediate breast reconstruction (IBR) can be offered to overcome the psychological burden caused by the dis gurement resulting from the loss of the breast [1].Skin-sparing mastectomy (SSM) can be followed by immediate breast reconstruction (IBR) using autologous tissue and/or prosthetic implants, and this approach has been advocated as an effective treatment option for patients with early-stage breast cancer which is not amenable to breastconserving therapy [2,3,4].e presence of the nipples seems fundamental to marking the identity of the breast
Based on the psychological impact of nipple-areola complex (NAC) removal in classical mastectomy techniques, several authors have evaluated the risk of nipple areola involvement and investigated the possibility of nipple areola preservation, but the risk of cancer recurrence in the breast tissue preserved beneath the NAC for the blood supply is considered a major reason to avoid NAC conservation during the mastectomy [5]
Given the thin nature of the residual areola tissue used for nipple reconstruction, there were, no instances of nipple necrosis as might be expected
Summary
Mastectomy represents the treatment of choice for approximately one-third of women with breast cancer due to aggressive, extensive, or multicentric tumour growth, contraindications for radiotherapy, or following the patient’s wish.To most of these cases, immediate breast reconstruction (IBR) can be offered to overcome the psychological burden caused by the dis gurement resulting from the loss of the breast [1].Skin-sparing mastectomy (SSM) can be followed by immediate breast reconstruction (IBR) using autologous tissue and/or prosthetic implants, and this approach has been advocated as an effective treatment option for patients with early-stage breast cancer which is not amenable to breastconserving therapy [2,3,4].e presence of the nipples seems fundamental to marking the identity of the breast. Mastectomy represents the treatment of choice for approximately one-third of women with breast cancer due to aggressive, extensive, or multicentric tumour growth, contraindications for radiotherapy, or following the patient’s wish To most of these cases, immediate breast reconstruction (IBR) can be offered to overcome the psychological burden caused by the dis gurement resulting from the loss of the breast [1]. Skin-sparing mastectomy (SSM) can be followed by immediate breast reconstruction (IBR) using autologous tissue and/or prosthetic implants, and this approach has been advocated as an effective treatment option for patients with early-stage breast cancer which is not amenable to breastconserving therapy [2,3,4]. In an 8-year-period 155 female patients (age: 20–52 years old; mean age: 37.5 years) with extensive ductal intraepithelial neoplasia (DIN) or invasive breast cancer were treated with areola skin sparing mastectomy with immediate nipple and breast reconstruction. Immediate nipple reconstruction a er skin-sparing mastectomy is a technically feasible procedure which can give excellent cosmetic results
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