Skin-sparing mastectomy.
The cosmetic appearance of the reconstructed breast is largely dependent upon the quantity of breast skin which remains after mastectomy. Leaving behind as much skin as is possible significantly improves the natural appearance of the reconstruction and reduces procedures required on the contralateral breast to achieve symmetry. SSM with immediate reconstruction offers superior aesthetic results to NSSM, with similar LR rates. As most recurrences will occur in chest wall skin, the ability to detect local recurrence is not impaired. The incidence of local wound complications with SSM is comparable to NSSM. It has been demonstrated that sentinel lymph node biopsy and axillary dissection can be performed adequately in SSM. There is no contraindication to postoperative adjuvant chemotherapy and radiation therapy. There are some groups of patients for whom SSM is not indicated, such as patients with inflammatory carcinoma. SSM should be considered for selected patients with breast cancer in conjunction with all types of immediate reconstruction. In conclusion, numerous studies support the use of SSM on selected patients as an oncologically acceptable procedure with superior cosmetic results when compared with traditional NSSM.
Simmons
Rache M
RM
Department of Surgery, The New York Presbyterian Hospital, Weill Medical College of Cornell University, 451 East 61st Street, New York, NY 10021, USA. rms2002@med.cornell.edu
Adamovich
Tara L
TL
D001943:Breast Neoplasms / Q000601:surgery*; D004954:Esthetics; D005260:Female; D006801:Humans; D015414:Mastectomy, Subcutaneous; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D018579:Patient Selection