Envelope mastectomy with immediate reconstruction (EMIR).
OBJECTIVE
To develop an oncologically safe and aesthetically acceptable technique for mastectomy, using a muscle flap and tissue expander through one incision.


METHODS
Twelve consecutive patients (mean age 40) underwent an envelope mastectomy (skin and nipple sparing), with immediate reconstruction with a latissimus dorsi muscle flap and tissue expander. Assessment of cosmesis was by review of pre- and post-operative photographs by an independent observer.


RESULTS
During follow-up there have been no recurrences. Assessment of cosmesis gave a score of 44 out of 48 (92%). One prosthesis was removed due to erosion of the prosthesis through the skin.


CONCLUSIONS
In patients with large lesions, multi-focal lesions (both invasive and in situ) and recurrent phyllodes tumours may undergo an oncologically safe mastectomy with immediate reconstruction through a single incision that is inconspicuous being in the mid-axillary line. Although follow up is only 8.5 months, long-term studies are being undertaken.
Sufi
P A
PA
The Breast Unit, Basildon Hospital, Nethermayne, Basildon, SS16 5NL, UK.
Gittos
M
M
Collier
D S
DS
D000328:Adult; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D015414:Mastectomy, Subcutaneous / Q000379:methods*; D013524:Surgical Flaps; D013997:Time Factors; D015625:Tissue Expansion Devices; D016896:Treatment Outcome