engleski

Seven year experience of early-stage breast cancer treatment with skin and nipple sparing mastectomy and immediate breast reconstruction

Introduction Skin sparing mastectomy, described by Toth and Lappert 1991, has been advocated as an oncologically safe approach for the management of patients with early-staged breast cancer that minimizes deformity and improves cosmetic result by preservation of the skin envelope of the breast. Verheyden 1998. described the nipple sparing total mastectomy for treating the premalignant lesions of the breast. Patients and methods Based on experiences of these and other authors, in past seven years we have treated 51 patients with premalignant breast lesions, DCIS and T1/T2 breast cancer with skin and nipple sparing mastectomy and immediate reconstruction. Pedicled deepithelized latissimus dorsi myocutaneus flap with or without breast implant was used in 23 patients and the deepitelized DIEP flap was used in 26 patients. Results Mean follow-up was 53 months. There were no local recurrences and the overall patient survival rate is 100%. The most frequent complication was partial areolar necrosis in 8 patients. In the patients reconstructed with DIEP flaps we had one total flap necrosis due to recurrent venous thrombosis. Conclusions According to our preliminary results from this ongoing study we can conclude that skin and nipple sparing mastectomy followed by immediate breast reconstruction is oncologically safe procedure in selected patients. Although the choice of reconstruction depends on various factors, in our opinion for majority of patients reconstruction with perforator flaps is a gold standard of breast reconstruction.

breast cancer; immediate breast reconstruction; skin sparing mastectomy; nipple sparing mastectomy

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