Background: Now, breast reconstruction after a mastectomy is being performed in many cases by using a tissue expander or a TRAM nap. However, a conventional mastectomy leaves long linear scar tissue which is also seen on the breast skin after breast reconstruction. A skin-sparing mastectomy with immediate reconstruction leaves minimal scar tissue, and with a circumareolar incision, it leaves no visible scar tissue.
Purpose: The purpose of this study is ① to identify the clinical indications for a skin-sparing mastectomy with immediate reconstruction, ② to evaluate the clinical results, and ③ to encourage the application of this method.
Methods: During the recent 20 months, there were 467 breast-cancer surgeryes; 368 metastectomes (78.8%, 368/467), and 30 mastectomes with breast reconstruction (8.2%, 30/368), Among the 30 reconstruction cases, a skin-sparing mastectomy with a circumareolar incision and immediate reconstruction was performed on 9 patients. Our patient selection criteria was as follows: ① patient´s desire for reconstruction from a cosmetic aspect, ② clinically early breast cancer, ③ moderate breast size, ④ centrally located tumor, and ⑤ no skin involvement.
Result: 1) We performed 9 skin-sparing mastectomies with a circumareolar incision and immediate reconstruction. 2) Three patient who complained of a palpable mass were diagnosed by FNA as having breast cancer. In the other 6 patient, the cancer was diagnosed by a ductal biopsy in 4 cases where the complaint was a bloody nipple discharge, by a H-wire biopsy in one case where mammography revealed multiple microcalcifications, and by a punch biopsy in one case where the nipple was eczematous. Preoperatively, cases were suspected of having early breast cancer. 3) Four cases were stage 0, 3 cases were stage Ⅰ, and 2 cases were stage Ⅲ in postoperative pathologic staging. 4) All the patients were satisfied with their cosmetic results.
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