Report on skin-sparing mastectomy with immediate breast reconstruction in 15 cases

Ligang LIU; Junlin ZHANG; Yongjin WU; Weiguo XIE; Jinsong ZHANG; Liang WANG; Zhen FANG; Gang CHEN; Jianmin FU; Peicheng MAI

ABSTRACT

BACKGROUND:

Recently the prevalence rate of mass in mammary gland increases significantly than before. To use which kind of technology is not only related with the post-operation recurrence, but also related with the reconstruction of their confidence. Therefore, how to reduce the trauma physically and psychologically in patients to the maximal degree has become the chief factor to choose technology by surgeons.

OBJECTIVE:

To observe the effects of transverse rectus abdominis musculocutaneous (TRAM) flap, latissimus dorsi musculocutaneous flap with breast prothesis, local flap and simple breast prothesis after skin-sparing mastectomy with immediate breast reconstruction.

DESIGN:

Case analysis.

SETTING:

Department of Plastic Surgery, Shenzhen People's Hospital,Second Clinical Medical College of Jinan University.

PARTICIPANTS:

A total of 15 ductal carcinoma in situ (DCIS) and huge breast benign tumor patients were enrolled into Shenzhen People's Hospital between October 1997 and May 2004, aged from 20 to 46 years. They all got disease in single breast, and 8 of them had preoperative diagnosis of DCIS, T1N0M0 and 7 of them had huge breast benign tumor. Operation program was informed to the patients before operation so as to gain their agreement.

METHODS:

Skin-sparing mastectomy was performed with circular shape incision at areola and using TRAM flap, latissimus dorsi musculocutaneous flap with breast prothesis, local flap and simple breast prothesis to fill breast. Slight skin of musculo-cutaneous flap could compensate the nipple and areola when performing reconstruction. At the reoperation, nipple was made at the transferred flap.MAIN OUTCOME

MEASURES:

To observe the patients with or without recurrence or transfer after operation and local healing of wound.

RESULTS:

With the cooperation of general surgeons the operation was done in 15 cases and 14 cases of them were followed up for more than 1 year. The reconstructed breasts were with good symmetry with the opposite one, normal skin sensation, natural shape and inconspicuous scar.

CONCLUSION:

This is an excellent alternative method for mastectomy and breast reconstruction based on the avoidance of recurrence of breast cancer in severe operation.