title: Endoscopic-assisted skin-sparing mastectomy combined with sentinel node biopsy.
abstract: Breast-conserving surgery (BCS) has been carried out as desirable choice for patients with early-stage breast cancer. However, many patients obliged to abandon BCS because of tumours accompanied by extended intraductal components or multiple tumours. The purpose of this study was to develop a novel endoscopic-assisted technique for skin-sparing mastectomy (SSM) combined with sentinel node biopsy (SNB), followed by immediate breast reconstruction with mammary prosthesis. Between April 2000 and November 2006, 33 patients diagnosed with primary breast cancer underwent endoscopic-assisted SSM. Immediate reconstruction with the mammary prosthesis was carried out in 30 of 33 patients. On postoperative histopathological diagnosis, 21 tumours were diagnosed as ductal carcinoma in situ or lobular carcinoma in situ. Twelve tumours were diagnosed as invasive carcinoma. Eight of 12 invasive carcinomas were accompanied by a wide spreading intraductal component. Two patients were diagnosed as having multicentric carcinomas, which made the standard breast-conserving treatment difficult. After a mean follow-up period of 51.2 months (range 16-86 months), neither locoregional recurrence nor distant metastasis has been detected. Thus, combining SSM and SNB with immediate reconstruction with the mammary prosthesis may offer the selected patients with early-stage breast cancer favourable aesthetic results without incurring additional oncological risks. The procedure could be an alternative treatment option for patients with widely spreading intraductal component or multiple tumours.
authors.affiliation: Division of Breast and Endocrine Surgery, Department of Surgery (II), Shinshu University School of Medicine, Matsumoto, Nagano, Japan. kenito@hsp.md.shinshu-u.ac.jp
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Ito
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Kanai
authors.forename: Kuniyuki
authors.initials: K
authors.lastname: Gomi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Watanabe
authors.forename: Tokiko
authors.initials: T
authors.lastname: Ito
authors.forename: Akira
authors.initials: A
authors.lastname: Komatsu
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Fujita
authors.forename: Jun
authors.initials: J
authors.lastname: Amano
mesh_terms: D000328:Adult; D000368:Aged; D019928:Breast Implantation; D018427:Breast Implants; D001943:Breast Neoplasms / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D021701:Sentinel Lymph Node Biopsy