Early Results of Subcutaneous Mastectomy with Immediate Breast Reconstruction as a Treatment for Early Breast Cancer

ABSTRACT

PURPOSE: Subcutaneous mastectomy, combined with immediate breast reconstruction has become popular for breast cancer management. This type of surgery allows for an improved cosmetic result. Although subcutaneous mastectomy is becoming more common, there is little data regarding the local recurrence (LR) rate after this procedure. METHODS: A total of 93 patients were treated for breast cancer by subcutaneous mastectomy with immediate breast reconstruction using permanent prosthesis at Yeungnam University Hospital from September 1996 to April 2003. The inclusion criteria for this procedure were peripherally located tumor, a tumor size smaller than T2, clinically negative axillary lymph node, and a grossly normal nipple and areolar area. To avoid recurrence at the nipple-areolar complex (NAC), a frozen biopsy of the NAC resection margin was performed in all cases. RESULTS: The mean follow-up period was 26 months, and the mean age of the patients was 40.2 years. According to the American Joint Committee on Cancer staging, the stage was as follows stage 0, 9 patients; stage I, 39 patients; and stage II, 45 patients. The overall LR rate was 5.4% (5 of 93 patients). The mean local relapse-free interval was 30 months. The sites of LR were at the peripheral breast tissue and at the NAC. Only one of 79 patients with preservation of the NAC developed LR at the NAC during the follow-up. LR at the NAC was low as 1.3%. No statistical differences in the LR rates were demonstrated between the NAC-spared group and the NAC-resected group (P>0.05). CONCLUSION: Subcutaneous mastectomy with immediate breast reconstruction using permanent prosthesis as a treatment for early breast cancer is a good treatment modality. Furthermore, preservation of the nipple-areolar complex increases the satisfaction of patients by improving the cosmetic result, and this procedure is both feasible and oncologically safe for breast cancer patients.