title: Clinical comparison of four types of skin incisions for skin-sparing mastectomy and immediate breast reconstruction.
abstract: OBJECTIVE
  Skin-sparing mastectomy (SSM) and immediate breast reconstruction (IBR) has become popular as an effective procedure for patients with early breast cancer. We herein report an overview of the four types of skin incisions used for SSM.
  
  
  METHODS
  The records of 111 consecutive breast cancer patients, who received SSM and IBR from 2003 to 2012, were reviewed retrospectively. Four types of skin incisions were used. Type A was the so-called tennis racquet incision, type B was a periareolar incision and mid-axillary incision, type C was the so-called areola-sparing with mid-axillary incision and type D was a small transverse elliptical incision and transverse axillary incision.
  
  
  RESULTS
  Twenty-six type A, 59 type B, 20 type C and six type D incisions were made. The average blood loss and average length of the operation during SSM were not significantly different between the four approaches. The average areolar diameter was 35 mm for type A, B and D incisions, and 45 mm for type C. There was a need for postoperative nipple-areolar complex plasty (NAC-P) in 75 % of the cases following type A, B and D incisions, and 35 % of the cases treated using type C incisions.
  
  
  CONCLUSIONS
  The type C incision is superior with regard to the cost and cosmetic outcomes, because fewer of these patients request postoperative NAC-P.
authors.affiliation: Department of Surgery, Jikei University Kashiwa Hospital, 163-1 Kashiwashita, Kashiwa, Chiba, 277-8567, Japan, satokino@jikei.ac.jp.
authors.forename: Satoki
authors.initials: S
authors.lastname: Kinoshita
authors.forename: Shigeya
authors.initials: S
authors.lastname: Kyoda
authors.forename: Akio
authors.initials: A
authors.lastname: Hirano
authors.forename: Tadashi
authors.initials: T
authors.lastname: Akiba
authors.forename: Kimihiro
authors.initials: K
authors.lastname: Nojima
authors.forename: Ken
authors.initials: K
authors.lastname: Uchida
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takeyama
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Morikawa
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000191:economics / Q000379:methods*; D015414:Mastectomy, Subcutaneous / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
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