The use of skin sparing mastectomy in the treatment of breast cancer: The Emory experience.
BACKGROUND
Long-term follow-up of the use of skin sparing mastectomy (SSM) in the treatment of breast cancer is presented to determine the impact of local recurrence (LR) on survival.


METHODS
565 cases of breast cancer were treated by SSM and IBR from 1/1/1989-12/31/1998. The AJCC pathological staging was Stage 0 175 (31%), Stage I 135 (23.9%), Stage II 173 (30.6%), Stage III 54 (9.6%), Stage IV 8 (1.4%), recurrent 20 (3.5%). Forty-one patients received postoperative adjuvant radiation therapy.


RESULTS
Thirty-one patients developed a LR during the follow-up including five who received adjuvant radiation. The distribution of LR stratified by cancer stage was Stage 0 1 (3.2%), Stage I 5 (16.1%), Stage II 17 (54.8%), Stage III 6 (19.4%), and recurrent 2 (6.5%). The overall LR was 5.5%. Isolated LRs were treated with surgical resection and radiation therapy if not previously administered. Twenty-four patients (77.4%) developed a systemic relapse and 7 (22.6%) patients remained free of recurrent disease at a mean follow-up of 78.1 months. The cancer stage of those remaining disease free was Stage 0 1, Stage I 4, and Stage II 2.


CONCLUSIONS
LR of breast cancer after SSM is not always associated with systemic relapse.
Winship Cancer Institute, Emory University School of Medicine, Emory University, 1365B, Clifton Road, Atlanta, GA 30322, USA. grant_carlson@emory.org
Grant W
GW
Carlson
Toncred M
TM
Styblo
Robert H
RH
Lyles
Glyn
G
Jones
Douglas R
DR
Murray
Charles A
CA
Staley
William C
WC
Wood
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D015331:Cohort Studies; D062109:Dermatologic Surgical Procedures; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D016462:Mammaplasty; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology; D009367:Neoplasm Staging; D011336:Probability; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018570:Risk Assessment; D013524:Surgical Flaps; D016019:Survival Analysis; D016896:Treatment Outcome