Skin sparing mastectomy with immediate reconstruction in early breast carcinoma: a preliminary study
Sriussadaporn, S.; Angspatt, A.
Journal of the Medical Association of Thailand 95(6): 775-781
2012
ISSN/ISBN: 0125-2208 PMID: 22774621 Document Number: 14952
Surgical treatment for breast cancer has some special aspects different from other cancers, since surgeons have to concern of both oncologic safety and esthetic outcome. Modified radical mastectomy (MRM) can give the oncologic safety but not esthetic outcome. Breast conserving therapy improves cosmetic but results in more local recurrence than modified radical mastectomy. Skin sparing mastectomy (SSM) with immediate reconstruction for early breast cancer has been reported by several investigators to have comparable outcome with MRM and better esthetic result. The purpose of the present study was to examine patients who underwent SSM with immediate reconstruction at King Chulalongkorn Memorial Hospital. Patients who underwent SSM with immediate reconstruction by the authors at King Chulalongkorn Memorial Hospital, Bangkok Thailand between May 2007 and January 2011 were studied. The immediate reconstruction was performed with transverse rectus abdominis musculocutaneous flaps or latissimus dorsi flaps. Postoperative early and late complications as well as local recurrence were studied to examine the oncologic safety and esthetic outcome. Fourteen patients were enrolled into the present study. The age ranged from 33 to 59 years (mean 47 years). The follow up time ranged from six to 50 months (mean 26.5 months). Postoperative complications included wound infection in one patient (7%), seroma at donor site of latissimus dorsi flaps in two patients (40%) and fat necrosis in five patients (55%). There was no skin flap necrosis, no hematoma, no arm numbness, no wound dehiscense, no abdominal wall hernia, and no lymphedema of the arm. No local recurrence was detected This preliminary report shows that skin-sparing mastectomy with immediate reconstruction is a good alternative in management of early breast cancer. There was no serious postoperative complication. The esthetic result was acceptable. No local recurrence was observed. Long-term follow up with more patients are required to confirm its applicability in early breast cancer patients.
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