Immediate Breast Reconstruction with TRAM Flap after Nipple-Areolar Sparing Mastectomy

ABSTRACT

PURPOSE: Skin-sparing mastectomy(SSM) with immediate breast reconstruction is becoming a proved option for early-stage breast cancer patients. Recently, skin-sparing mastectomy with preserving the nipple- areolar complex is becoming popular procedure. METHODS: During a 13-month period, from April 2004 to January 2005, 101 cases of immediate breast reconstructions with pedicled TRAM flap were performed after 40 cases of nipple-areolar sparing mastectomies, 57 cases of skin-sparing mastectomies and 4 cases of modified radical mastectomies. RESULTS: During the 11 months follow up period, necrosis of mastectomy skin flap occurred in 17.5% (n=10) after skin-sparing mastectomy and necrosis of mastectomy skin flap and nipple-areolar necrosis occurred in 30%(n=12) after nipple-areolar sparing mastectomy. These complications were healed after simple dressing without any surgical procedure. CONCLUSION: Nipple-areolar sparing mastectomy and immediate breast reconstruction with TRAM flap is good option for early breast cancer patients and some modifications are needed to reduce skin necrosis.