Local and distant recurrence rates in skin-sparing mastectomies compared with non-skin-sparing mastectomies.
BACKGROUND
Skin-sparing mastectomies (SSMs) are being used more frequently to treat many cases of breast cancer. This type of surgery maximizes breast skin preservation and facilitates immediate reconstruction, resulting in a superior cosmetic appearance after mastectomy and a more satisfied patient. Although SSMs are becoming more common, there are few data regarding the local and distant recurrence rates.


METHODS
A total of 231 patients treated with mastectomies from 1990 to 1998 were studied, including 77 SSM and 154 non-skin-sparing (NSSM) mastectomy patients.


RESULTS
The local recurrence rates for SSM and NSSM were 3.90% (3 of 77 patients) and 3.25% (5 of 154 patients), respectively. The local recurrence-free survival at 5 years was 95.3% for SSM patients and 95.2% for NSSM patients (P = .28). The distant recurrence rates of SSM and NSSM were 3.9% (3 of 77 patients) and 3.9% (6 of 154 patients), respectively. The distant recurrence-free actuarial survival at 5 years was 90.2% for SSM patients and 92% for NSSM patients (P = .07).


CONCLUSIONS
Mastectomies using the skin-sparing technique do not appear to result in any increase in local or distant recurrence and improve aesthetic results of the immediate reconstruction.
Simmons
R M
RM
Strang-Cornell Breast Center, New York, New York, USA.
Fish
S K
SK
Gayle
L
L
La Trenta
G S
GS
Swistel
A
A
Christos
P
P
Osborne
M P
MP
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D016022:Case-Control Studies; D062109:Dermatologic Surgical Procedures; D005260:Female; D006801:Humans; D016462:Mammaplasty; D015411:Mastectomy, Modified Radical / Q000379:methods*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome