Equivalent Oncologic Outcomes of Skin-Sparing Mastectomy with Immediate Breast Reconstruction in Early Stage Breast Cancer Patients in a Single Center Study
Lohsiriwat V, MD1, Preechakul S, MD1, Lohasammakul S, MD2, Chuangsuwanich A, MD2, O-charoenrat P, MD, PhD1, Chuthapisith S, MD, PhD1, Ratanawichitrasin A, MD1, Pisarnturakit P, MD1, Boonsripitayanon M, MD1, Rushatamukayanunt P, MD, PhD1, Imruetaicharoenchoke W, MD, PhD1, Numprasit W, MD1, Sa-nguanraksa D, MD, PhD1, Tarapongpun T, MD1
Affiliation : 1 Division of Head-Neck and Breast Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand 2 Division of Plastic and Reconstructive Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : Skin-sparing mastectomy (SSM) is a novel operation that offers better aesthetic outcomes than conventional mastectomy
(total mastectomy (TM) or modified radical mastectomy (MRM)). For oncologic safety, it is widely accepted that SSM with immediate
breast reconstruction (IBR) offers no statistically significant difference in terms of locoregional recurrence and distant metastasis
when performed in early stage breast cancer. The present study aimed to study the oncological safety of SSM with IBR in Tis–T2
breast cancer patients in an Asian population.
Materials and Methods : The data of breast cancer patients who underwent SSM or TM both with IBR from January 2005 to December
2013 were retrospectively reviewed. The inclusion criteria were a pathological in situ or invasive breast cancer sized <5 cm and
a follow-up duration of at least 24 months. A comparison of locoregional recurrences, distant metastasis, 5-year disease-free, and
overall survival rates between the two groups was performed and the results analyzed.
Results : The authors identified 291 patients (292 operations). The median follow-up times were 81 months in the TM group (n =
148) and 59 months in the SSM group (n = 144). There was no statistically significant difference in tumor characteristics or AJCC
staging, except for a higher positive hormonal receptor status in the SSM group. There was no difference in the rates of locoregional
recurrences, distant metastasis, 5-year disease-free, and overall survival between the two groups.
Conclusion : SSM is a good option for mastectomy because the preserved skin provides a better aesthetic outcome and there was
no difference in recurrence rates between TM and SSM with IBR in breast cancer. Also, the 5-year disease-free and overall survival
rates were comparable between both groups. SSM with IBR should therefore be considered an oncologically safe operation in
breast cancers less than 5 cm in size.
Keywords : Breast cancer, Oncological safety, Skin sparing mastectomy, Conventional mastectomy, Immediate breast reconstruction
