Published online May 10, 2014. doi: 10.5306/wjco.v5.i2.33
Revised: February 20, 2014
Accepted: March 13, 2014
Published online: May 10, 2014
Skin sparing mastectomy (SSM) can facilitate immediate breast reconstruction and is associated with an excellent aesthetic result. The procedure is safe in selected cases; including invasive tumours < 5 cm, multi-centric tumours, ductal carcinoma in situ and for risk-reduction surgery. Inflammatory breast cancers and tumours with extensive involvement of the skin represent contra-indications to SSM due to an unacceptable risk of local recurrence. Prior breast irradiation or the need for post-mastectomy radiotherapy do not preclude SSM, however the aesthetic outcome may be compromised. Preservation of the nipple areola complex is safe for peripherally located node negative tumours. An intraoperative frozen section protocol for the retro-areolar tissue should be considered in these cases. The advent of acellular tissue matrix systems has enhanced the scope of implant-based immediate reconstruction following SSM. Cell-assisted fat transfer is emerging as a promising technique to optimise the aesthetic outcome.
Core tip: Skin sparing mastectomy (SSM) is oncologically safe in selected cases and is aesthetically superior to simple mastectomy. New techniques such as the use of acellular dermal matrix a and cell-assisted fat transfer have enhanced the use of implants for volume replacement following SSM.