A Study on Skin-Sparing Mastectomy in Patients Ineligible for Breast-Conserving Therapy

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Background: Although breast-conserving therapy consisting of wide excision followed by radiation therapy has been established as a standard treatment for breast cancer, a number of patients are ineligible for this treatment option. We carry out skin-sparing mastectomy (SSM) with immediate breast reconstruction for such patients. This study assessed therapeutic outcomes with SSM in patients treated at our department.
Patients and Methods: Thirteen patients who underwent an SSM with immediate breast reconstruction between November 2000 and October 2002 were reviewed. Fourteen patients treated by a conventional non-skin-sparing mastectomy (NSSM) with immediate breast reconstruction during the same period served as controls.
Results: The SSM technique was used more often in patients with ductal carcinoma in situ (DCIS) or early-stage cancer including T1 (P = 0.0132). Minor flap necrosis was observed in 2 patients who underwent an SSM and in 1 who underwent an NSSM postoperatively. Two patients (14.3%) who underwent an NSSM presented with local recurrences and 3 (21.4%) with distant metastases. It is remarkable that no patients who underwent an SSM presented with local recurrence and 1 (7.7%) with distant metastasis.
Conclusion: SSM with immediate breast reconstruction is a preferable surgical option for patients ineligible for breastconserving therapy, especially those with wide-spreading DCIS.