Evaluation of result of skin-nipple sparing mastectomy in Baghdad Teaching Hospital and Dijla Private Hospital
DOI:
https://doi.org/10.18203/2349-2902.isj20183418Keywords:
Breast, Cancer, Mastectomy, Nipple, SparingAbstract
Background: Skin-nipple sparing mastectomy and immediate breast reconstruction by silicone implantation has become increasingly popular as an effective treatment for patients with breast carcinoma. The aim of this study was to evaluate the results of skin-nipple sparing mastectomy.
Methods: Records of twenty-seven patients with operable breast cancer who had skin-nipple sparing mastectomy and immediate breast reconstruction between June 2009 and June 2011 were reviewed. Patients and tumor characteristic, type of reconstruction, post-operative complication, aesthetics, results and incidence of recurrence analyzed.
Results: Mean age of 37 patients, aged 25 to 48 years old. Regarding the clinical feature, the size of mass <3 cm in 70%, the site of mass in upper outer quadrant in 62%, no case of skin changes and/or nipple changes. There are two cases of all patients which fixed to underlying tissues about 63% of cases are grade II, stage II and 37% are grade I, stage I. The results of follow up of the procedures are: seroma developed in 14%, infection 3.5%, skin necrosis 7%, local recurrence was zero for follow up for more than one year, about 63% received chemotherapy.
Conclusions: S.N.S.M. and immediate breast reconstruction with silicon implantation for selective case of CA breast is associated with low morbidity and low rate of local recurrence and good aesthetic result with patient satisfaction.
Metrics
References
Osborn G. Management of breast cancer: basic principles. Surgery-Oxford International Edition; 2013;31(1):27-31.
Shokuhi S, Parker S. Management of breast cancer: basic principles. Surgery (Oxford); 2007;25(6):261-3.
Mastectomy R. Halsted Radical Mastectomy. The Breast E-Book: Comprehensive Management of Benign and Malignant Diseases. Elsevier; 2017:422.
Fann JR, Thomas-Rich AM, Katon WJ, Cowley D, Pepping M, McGregor BA, et al. Major depression after breast cancer: a review of epidemiology and treatment. General Hospital Psychiatry. 2008;30(2):112-26.
Iddings DM, Fleisig AJ, Chen SL, Faries MB, Morton DL. Practice patterns and outcomes for anorectal melanoma in the USA, reviewing three decades of treatment: is more extensive surgical resection beneficial in all patients? Ann Surg Oncol. 2010;17(1):40-4.
Rebbeck TR, Friebel T, Lynch HT, Neuhausen SL, van’t Veer L, Garber JE, et al. Bilateral prophylactic mastectomy reduces breast cancer risk in BRCA1 and BRCA2 mutation carriers: the PROSE Study Group. J Clin Oncol. 2004;22(6):1055-62.
Gerber B, Krause A, Reimer T, Müller H, Küchenmeister I, Makovitzky J, et al. Skin-sparing mastectomy with conservation of the nipple–areola complex and autologous reconstruction is an oncologically safe procedure. Ann Surg. 2003;238(1):120.
De La Cruz L, Moody AM, Tappy EE, Blankenship SA, Hecht EM. Overall survival, disease-free survival, local recurrence, and nipple–areolar recurrence in the setting of nipple-sparing mastectomy: a meta-analysis and systematic review. Ann Surg Oncol. 2015;22(10):3241-9.
Reis‐Filho J, Lakhani S. Breast cancer special types: why bother? J Pathol. 2008;216(4):394-8.
Toth BA, Lappert P. Modified skin incisions for mastectomy: the need for plastic surgical input in preoperative planning. Plastic Reconstructive Surg. 1991;87(6):1048-53.
Veronesi U, Stafyla V, Petit JY, Veronesi P. Conservative mastectomy: extending the idea of breast conservation. The Lancet Oncol. 2012;13(7):e311-e7.
Nahabedian MY, Tsangaris TN. Breast reconstruction following subcutaneous mastectomy for cancer: a critical appraisal of the nipple-areola complex. Plastic Reconstructive Surg. 2006;117(4):1083-90.
Simmons RM, 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.
Mallon P, Feron JG, Couturaud B, Fitoussi A, Lemasurier P, Guihard T, et al. The role of nipple-sparing mastectomy in breast cancer: a comprehensive review of the literature. Plastic Reconstructive Surg. 2013;131(5):969-84.
Fersis N, Relakis K, Bastert G, Wallwiener D. Breast reconstruction with the “Fleur de lis” technique of the latissimus dorsi myocutaneous flap: Cosmetic results and complications. Obstet Gynecol. 2000;60(12):625-9.