Skin-sparing mastectomy.
BACKGROUND
Skin-sparing mastectomy (SSM) is a new technique being used in a variety of clinical settings. This article reviews the published data on SSM to establish its current role in clinical practice.


METHODS
A Medline search was carried out using the key words 'skin-sparing mastectomy' to identify English-language articles published between 1990 and 2004 and further material referenced in these publications.


RESULTS
SSM is most commonly used for surgical prophylaxis and to treat in situ and early invasive disease in patients who request immediate breast reconstruction. SSM and non-SSM result in similar surgical and oncological outcomes, but skin flap ischaemia is more common after SSM and is associated with a range of risk factors, including smoking.


CONCLUSIONS
SSM has become an established procedure in breast surgery, but there is a lack of prospective data on which to make evidence-based decisions about its use in individual patients.
Rainsbury
R M
RM
Breast Unit, Royal Hampshire County Hospital, Romsey Road, Winchester SO22 5DG, UK. rrainsbury@aol.com
D001943:Breast Neoplasms / Q000098:blood supply / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000098:blood supply / Q000601:surgery*; D000075202:Contraindications; D062109:Dermatologic Surgical Procedures; D005260:Female; D006801:Humans; D007511:Ischemia / Q000209:etiology; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors; D012867:Skin / Q000098:blood supply; D012907:Smoking / Q000009:adverse effects; D013524:Surgical Flaps; D016896:Treatment Outcome