title: Long-term oncological results after 400 skin-sparing mastectomies.
abstract: OBJECTIVE
  Skin-sparing mastectomies (SSM) have gained acceptance among teams performing immediate breast reconstruction because this technique provides the best cosmetic outcome. Nevertheless, in France, concerns have been raised that limited skin excision during mastectomy could result in an increased risk of local recurrence especially in invasive breast cancer; many surgeons continue to have reservations regarding the oncologic safety of this operation. This is a retrospective, long-term follow-up study of 400 patients operated and followed by two oncoplastic surgeons.
  
  
  METHODS
  A total of 400 patients with breast cancer underwent SSM with immediate breast reconstruction from January 1, 1992 to December 31, 2002. The American Joint Committee on Cancer pathological staging was Stage 0 (41.5%), Stage I (33.25%), Stage II (16%), Stage III (7.5%), while 1.75% were non-stageable.
  
  
  RESULTS
  With a mean follow-up period of 88 months (range: 13-215 months), the locoregional recurrence rate was 3.5%, the rate of distant metastases was 13.5%, and 83% of patients have remained free of recurrent disease.
  
  
  CONCLUSIONS
  This study provides encouraging results suggesting that skin-sparing mastectomy is a safe and reliable option for the management of selected cases of women with invasive or in situ breast cancer.
authors.affiliation: Unité de chirurgie carcinologique et reconstructrice mammaire, Centre hospitalier Princesse-Grace, avenue Pasteur, 98000 Monaco, Monaco. Electronic address: marie-christine.missana@chpg.mc.
authors.forename: M C
authors.initials: MC
authors.lastname: Missana
authors.forename: I
authors.initials: I
authors.lastname: Laurent
authors.forename: M
authors.initials: M
authors.lastname: Germain
authors.forename: S
authors.initials: S
authors.lastname: Lucas
authors.forename: L
authors.initials: L
authors.lastname: Barreau
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000379:methods; D008408:Mastectomy / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D009367:Neoplasm Staging; D012086:Reoperation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013524:Surgical Flaps
keywords: Breast cancer; Recurrence risk; Skin-sparing mastectomy