SS  Vol.3 No.4 , April 2012
Skin Sparing Mastectomy in Locally Advanced Breast Cancer: A Possibility?
Abstract: Breast cancer is the second most common cause of cancer death in women in India in spite of advances in the adjuvant treatment of breast cancer. Locally advanced breast cancer (LABC) still represents the major presenting picture in many urban and rural institutions in our country. Skin Sparing Mastectomy (SSM) and primary reconstruction is a popular option for patients with breast cancer. There are similar local and distant recurrences in SSM compared to the traditional non-skin sparing mastectomy. A 57-year-old lady presented with a locally advanced left breast cancer. After undergoing neoadjuvant chemotherapy and a PET-CT to accurately detect residual disease in breast and axilla, she underwent skin sparing mastectomy with nipple-areola complex preservation and primary reconstruction with silicon prosthesis implant over a latissimus dorsi myocutaneous flap for primary reconstruction. SSM in LABC has not been reported in the literature so far. This patient is disease free for the past 24 months.
Cite this paper: V. Murthy, K. Gopinath and A. Krishna, "Skin Sparing Mastectomy in Locally Advanced Breast Cancer: A Possibility?," Surgical Science, Vol. 3 No. 4, 2012, pp. 226-231. doi: 10.4236/ss.2012.34044.

[1]   [1] N. S. Murthy, K. Chaudhry, D. Nadayil, U. K. Agarwal and S. Saxena, “Changing Trends in Incidence of Breast Cancer: Indian Scenario,” Indian Journal of Cancer, Vol. 46, No. 1, 2009, pp. 73-74. doi:10.4103/0019-509X.48603

[2]   A. K. Goel, V. Seenu, N. K. Shukla and V. Raina, “Breast Cancer Presentation at a Regional Cancer Center,” National Medical Journal of India, Vol. 8, 1995, pp. 6-9.

[3]   National Comprehensive Cancer Network, “Practice Guide-Lines in Oncology, v.3.2010,” Accessed on 23 November 2010.

[4]   K. Dalus, G. Rendl, L. Rettenbacher and C. Pirich, “FDG PET/CT for Monitoring Response to Neoadjuvant Chemotherapy in Breast Cancer Patients,” European Journal of Nuclear Medicine and Molecular Imaging, Vol. 37, No. 10, 2010, pp. 1992-1993. doi:10.1007/s00259-010-1585-z

[5]   D. Groheux, S. Giacchetti, D. Rubello, A. Al-Nahhas and J. L. Moretti, “The Evolving Role of PET/CT in Breast Cancer,” Nuclear Medicine Communications, Vol. 31, No. 4, 2010, pp. 271-273. doi:10.1097/MNM.0b013e3283354cb4

[6]   B. A. Toth and P. Lappert, “Modified Skin Incision for Mastectomy: The Need for Plastic Surgical Input in Preoperative Planning,” Plastic and Reconstructive Surgery, Vol. 87, No. 6, 1991, pp. 1048-1053. doi:10.1097/00006534-199106000-00006

[7]   M. Salhab, W. Al Sarakbi, A. Joseph, S. Sheards, J. Travers and K. Mokbel, “Skin-Sparing Mastectomy and Immediate Breast Reconstruction: Patient Satisfaction and Clinical Outcome,” International Journal of Clinical Oncology, Vol. 11, No. 1, 2006, pp. 51-54. doi:10.1007/s10147-005-0538-1

[8]   P. A. Ganz, A. Coscarelli, C. Fred, et al., “Breast Cancer Survivors: Psychosocial Concerns and Quality of Life,” Breast Cancer Research and Treatment, Vol. 38, No. 2, 1996, pp. 183-199. doi:10.1007/BF01806673

[9]   D. K. Wellisch, W. S. Schain, R. B. Noone, et al., “The Psychological Contribution of Nipple Addition in Breast Reconstruction,” Plastic and Reconstructive Surgery, Vol. 80, No. 5, 1987, pp. 699-704. doi:10.1097/00006534-198711000-00007

[10]   B. Gerber, A. Krause, M. Dieterich, G. Kundt and T. Reimer, “The Oncologic Safety of Skin Sparing Mastectomy with Conservation of the Nipple-Areola Complex and Autologous Reconstruction: An Extended Follow-Up Study,” Annals of Surgery, Vol. 249, No. 3, 2009, pp. 461-468. doi:10.1097/SLA.0b013e31819a044f

[11]   A. Denewer and O. Farouk, “Can Nipple-Sparing Mastectomy and Immediate Breast Reconstruction with Modified Extended Latissimus Dorsi Muscular Flap Improve the Cosmetic and Functional Outcome among Patients with Breast Carcinoma?” World Journal of Surgery, Vol. 31, No. 6, 2007, pp. 1169-1177. doi:10.1007/s00268-007-9046-y

[12]   H. M. Abdalla, M. A. Shalaan and F. A. Fouad, “Immediate Breast Reconstruction with Expander Assisted Latissimus Dorsi Flap after Skin Sparing Mastectomy,” Journal of the Egyptian National Cancer Institute, Vol. 18, No. 2, 2006, pp. 134-140.

[13]   S. A. Salvin, S. J. Schnitt and R. B. Duda, “Skin-Sparing Mastectomy and Immediate Reconstruction: Oncologic Risks and Aesthetic Results in Patients with Early-Stage Breast Cancer,” Plastic and Reconstructive Surgery, Vol. 102, No. 1, 1998, pp. 49-62. doi:10.1097/00006534-199807000-00008

[14]   R. M. Simmons, S. K. Fish, L. Gayle, G. S. Trenta, A. Swistel, et al., “Local and Distant Recurrence Rates in Skin-Sparing Mastectomies Compared with Non-Skin-Sparing Mastectomies,” Annals of Surgical Oncology, Vol. 6, No. 7, 1999, pp. 676-681. doi:10.1007/s10434-999-0676-1