Skin sparing mastectomy


Preserves the breast skin envelope except for the nipple-areola complex.

Locoregional recurrence rates for this procedure ranged from 4.5 to 7%, similar to conventional mastectomy (Kroll SS).

This technique is designed to be conjoined with immediate breast reconstruction using implant based or autologous tissue.

Implant reconstruction can be performed in one stage with placement at the time of mastectomy, or in two stages with a tissue expander placed at the time of mastectomy and exchange with a permanent implant.

Skin sparing mastectomy and nipple sparing mastectomy initially were reserved for risk reducing procedures such as BRCA mutation carriers, but in the past two decades these techniques have become increasingly popular for the treatment of breast cancer, both invasive and DCIS.
Skin sparing mastectomy and nipple sparing mastectomy keep the large part of the native breast skin envelope to match the natural breast.
Treatment with skin sparing mastectomy or nipple sparing mastectomy with or without supportive materials results in satisfactory cosmetic outcomes, often times.

Autologous tissue reconstruction procedures may include the transfers rectus abdominus myocutaneous flap (TRAM), deep inferior epigastric pedicle flap, gracilis tensor fascia lata flap, and latissmus dorsi flap.

Some studies did not find an increase in recurrence rates if the skin sparing mastectomy or nipple sparing mastectomy compared with modified radical mastectomy.
MRI studies show that 3% of patients have gross residual breast tissue after mastectomy, 13% after skin sparing mastectomy, and more than 50% of patients after nipple sparing mastectomy.

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