Clinical Comparison of Four Types of Skin Incisions for Skin-sparing Mastectomy and Immediate Breast Reconstruction

Overview

Journal Surg Today

Specialty General Surgery

Date 2013 Sep 18

PMID 24043394

Citations 4

Authors

Satoki Kinoshita

Shigeya Kyoda

Akio Hirano

Tadashi Akiba

Kimihiro Nojima

Ken Uchida

Hiroshi Takeyama

Toshiaki Morikawa

Affiliations

Soon will be listed here.

Abstract

Purpose: 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.

Conclusion: The type C incision is superior with regard to the cost and cosmetic outcomes, because fewer of these patients request postoperative NAC-P.

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References

Kinoshita S, Nojima K, Takeishi M, Imawari Y, Kyoda S, Hirano A . Retrospective comparison of non-skin-sparing mastectomy and skin-sparing mastectomy with immediate breast reconstruction. Int J Surg Oncol. 2012; 2011:876520. PMC: 3263672. DOI: 10.1155/2011/876520. View

. Results of questionnaires concerning breast cancer surgery in Japan: an update in 2000. Breast Cancer. 2002; 9(1):1. View

Singletary S, Kroll S . Skin-sparing mastectomy with immediate breast reconstruction. Adv Surg. 1996; 30:39-52. View

Fisher B, Fisher E . Barrier function of lymph node to tumor cells and erythrocytes. II. Effect of x-ray, inflammation, sensitization and tumor growth. Cancer. 1967; 20(11):1914-9. DOI: 10.1002/1097-0142(196711)20:11<1914::aid-cncr2820201118>3.0.co;2-q. View

Fisher B . From Halsted to prevention and beyond: advances in the management of breast cancer during the twentieth century. Eur J Cancer. 2000; 35(14):1963-73. DOI: 10.1016/s0959-8049(99)00217-8. View

Rainsbury R . Skin-sparing mastectomy. Br J Surg. 2006; 93(3):276-81. DOI: 10.1002/bjs.5257. View

Fisher B, Anderson S, Bryant J, Margolese R, Deutsch M, Fisher E . Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002; 347(16):1233-41. DOI: 10.1056/NEJMoa022152. View

Simmons R, Hollenbeck S, Latrenta G . Two-year follow-up of areola-sparing mastectomy with immediate reconstruction. Am J Surg. 2004; 188(4):403-6. DOI: 10.1016/j.amjsurg.2004.07.001. View

Simmons R, Adamovich T . Skin-sparing mastectomy. Surg Clin North Am. 2003; 83(4):885-99. DOI: 10.1016/S0039-6109(03)00035-5. View

10.

Fisher B, Redmond C, Fisher E . The contribution of recent NSABP clinical trials of primary breast cancer therapy to an understanding of tumor biology--an overview of findings. Cancer. 1980; 46(4 Suppl):1009-25. DOI: 10.1002/1097-0142(19800815)46:4+<1009::aid-cncr2820461326>3.0.co;2-h. View

11.

Lanitis S, Tekkis P, Sgourakis G, Dimopoulos N, Mufti R, Hadjiminas D . Comparison of skin-sparing mastectomy versus non-skin-sparing mastectomy for breast cancer: a meta-analysis of observational studies. Ann Surg. 2010; 251(4):632-9. DOI: 10.1097/SLA.0b013e3181d35bf8. View

12.

Kijima Y, Yoshinaka H, Hirata M, Mizoguchi T, Ishigami S, Arima H . Immediate reconstruction using a modified inframammary adipofascial flap after partial mastectomy. Surg Today. 2012; 43(4):456-60. PMC: 3599167. DOI: 10.1007/s00595-012-0390-7. View

13.

Lim W, Ko B, Kim H, Lee J, Eom J, Son B . Oncological safety of skin sparing mastectomy followed by immediate reconstruction for locally advanced breast cancer. J Surg Oncol. 2010; 102(1):39-42. DOI: 10.1002/jso.21573. View

14.

Veronesi U, Valagussa P . Inefficacy of internal mammary nodes dissection in breast cancer surgery. Cancer. 1981; 47(1):170-5. DOI: 10.1002/1097-0142(19810101)47:1<170::aid-cncr2820470128>3.0.co;2-c. View

15.

Patani N, Devalia H, Anderson A, Mokbel K . Oncological safety and patient satisfaction with skin-sparing mastectomy and immediate breast reconstruction. Surg Oncol. 2007; 17(2):97-105. DOI: 10.1016/j.suronc.2007.11.004. View

16.

Fisher B, Fisher E . Transmigration of lymph nodes by tumor cells. Science. 1966; 152(3727):1397-8. DOI: 10.1126/science.152.3727.1397. View

17.

Fisher B, Bauer M, MARGOLESE R, POISSON R, Pilch Y, Redmond C . Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer. N Engl J Med. 1985; 312(11):665-73. DOI: 10.1056/NEJM198503143121101. View

18.

Simmons R, Brennan M, Christos P, King V, Osborne M . Analysis of nipple/areolar involvement with mastectomy: can the areola be preserved?. Ann Surg Oncol. 2002; 9(2):165-8. DOI: 10.1007/BF02557369. View

19.

Halsted W . I. The Results of Radical Operations for the Cure of Carcinoma of the Breast. Ann Surg. 1907; 46(1):1-19. PMC: 1414357. DOI: 10.1097/00000658-190707000-00001. View

20.

Foster R, Esserman L, Anthony J, Do H . Skin-sparing mastectomy and immediate breast reconstruction: a prospective cohort study for the treatment of advanced stages of breast carcinoma. Ann Surg Oncol. 2002; 9(5):462-6. DOI: 10.1007/BF02557269. View