Immediate reconstruction after complete skin-sparing mastectomy with autologous tissue.
BACKGROUND
Immediate breast reconstruction with autologous tissue can re-create a breast mound that closely resembles the native breast in shape and consistency. Results are limited by scarring and color differences between flap and native breast skin. This study reviews all patients undergoing complete skin-sparing mastectomy with immediate autologous tissue reconstruction over the past 4 years.


METHODS
Twenty-eight patients with a mean age of 43 years (range, 32-53 years) were retrospectively reviewed. Requirements for the complete skin-sparing approach included a favorable biopsy scar location, adequate areolar diameter, and suitable donor site for autologous tissue reconstruction. Ninety-two percent of patients were reconstructed with a transverse rectus abdominis musculocutaneous flap.


RESULTS
There were no instances of flap loss or local recurrence during the followup period (mean, 27 months; range, 14-48 months). Complications at the reconstruction site were minor and limited to cellulitis, periareolar skin loss, and the need for repeat skin excision because of a very close pathologic margin. Donor site complications were seen in five patients. Aesthetic results were judged as excellent or good in 75% of patients.


CONCLUSIONS
Complete skin-sparing mastectomy with immediate autologous tissue reconstruction has enhanced immediate breast reconstruction by reducing scar burden and eliminating color differences without an increased incidence of local recurrence. This procedure is limited by appropriate patient selection and technical expertise in performing the mastectomy.
Hidalgo
D A
DA
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Borgen
P J
PJ
Petrek
J A
JA
Heerdt
A H
AH
Cody
H S
HS
Disa
J J
JJ
D000328:Adult; D001706:Biopsy; D001943:Breast Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D013524:Surgical Flaps