In a nutshell
This paper studied the outcomes of a skin-sparing mastectomy procedure.
Some background
More and more people are undergoing skin-sparing mastectomies. This is a treatment for breast cancer where breast tissue is removed, but the overlying skin is preserved as much as possible. It also allows for immediate breast reconstruction. However, there is worry that skin-sparing mastectomy leads to increased local recurrence rates (return of cancer) compared to conventional mastectomy. The recommended standard is <5% of local recurrence at 5 years after mastectomy while the desired target is less than 3% of local recurrence at 5 years.
Methods & findings
The authors aimed to identify the 5-year recurrence rates associated with skin-sparing mastectomy.
81 patients who had skin-sparing mastectomy and immediate breast reconstruction were analyzed. Information about their type of breast cancer and outcome of their mastectomy was obtained.
Regarding tumour characteristics, 48 were invasive tumours (cancer spreads outside of duct or lobule into breast tissue) and 34 were non-invasive tumours. 37.8% of patients had ductal (cancer from ducts of breast) tumours while 7.3% had lobular (cancer from lobules) tumours. 37.8% of patients had ductal carcinoma in-situ (cancer only in the milk ducts). 84% of tumors were estrogen receptor-positive while 8.5% of tumors were human epidermal growth factor recepror (HER2)-positive.
At an average follow-up time of 23.9 months, overall 2 patients (2.5%) experienced tumour recurrence, both of whom had invasive disease. This resulted in a recurrence rate of 4% for patients with invasive disease. One patient had both local recurrence (cancer at original site) and recurrence to the liver. The second patient had recurrence to the brain and liver.
The average disease-free survival (time between surgery and recurrence or death from unrelated causes) was 24.4 months. Specifically for in-situ cancer, the average disease-free survival was 26.9 months.
During the study period, 9.6% of patients had an infection after surgery or problems with wound healing. 3.6% of patients had a loss of breast implant.
The bottom line
The authors concluded that skin-sparing mastectomy does not increase risk of local recurrence compared with conventional mastectomy.
The fine print
This was a short term study, longer studies are warranted.
What’s next?
If considering mastectomy for breast cancer, discuss the possibility of skin-sparing techniques with your doctor.
Published By :
Clinical Breast Cancer
Date :
Oct 08, 2013
