The surgical treatment of breast cancer has evolved rapidly in recent decades. Conservative treatment was adopted in the late 1970s, with rates above 70%, and this was followed by a period during which the indications for surgical intervention were expanded to those patients at high risk for BRCA1, BRCA2 mutations, and also due to new staging standards and use of nuclear magnetic resonance. This increase in the indications for mastectomy coincided with the availability of immediate breast reconstruction as an oncologically safe and important surgical procedure for prevention of sequelae. Immediate reconstruction was first aimed at correcting the consequences of treatment, and almost immediately, the challenge of the technique became the achievement of a satisfactory breast appearance and shape, as well as normal consistency. The skin-sparing mastectomy (SSM) in conservation first and nipple-areola complex (NAC) later was a result of this shift that occurred from the early 1990s to the present. The objective of this review is to present all these developments specifically in relation to SSM and analyze our personal experience as well as the experience of surgeons worldwide with an emphasis on the fundamental aspects, indications, surgical technique, complications, oncological safety, and cosmetic results of this procedure.
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http://dx.doi.org/10.3978/j.issn.2227-684X.2015.04.21 | DOI Listing |
BMJ Open
January 2025
Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
Introduction: Despite its therapeutic advantages, postmastectomy radiotherapy (PMRT) increases the risk of complications and often leads to poor cosmesis in women undergoing breast reconstruction. Preoperative radiotherapy followed by skin-sparing mastectomy and deep inferior epigastric perforator (DIEP) flap reconstruction is technically feasible, with low rates of surgical complications and good short-term oncological outcomes. Further evaluation in a randomised trial comparing preoperative radiotherapy versus conventional PMRT in breast reconstruction is required to assess both oncological and patient-reported outcomes (PROs).
View Article and Find Full Text PDFIntroduction: Triple-negative breast cancer (TNBC) accounts for approximately 15-20% of all breast carcinomas. In the last two decades, both nipple-sparing mastectomy (NSM) and skin-sparing mastectomy (SSM) with immediate reconstruction have been used in the surgical management. The aim of our study was to analyze the outcomes of the combined treatment of patients with TNBC treated with NSM or SSM.
View Article and Find Full Text PDFJ Surg Case Rep
January 2025
Department of Plastic and Reconstructive Surgery, University of South Dakota Sanford School of Medicine, 1500 W. 22nd St. Suite 101, Sioux Falls, SD 57105, United States.
Achieving satisfactory nipple esthetics following skin-sparing or nipple-sparing mastectomy is an important element of ensuring positive patient outcomes. Several techniques used to reconstruct the nipple-areolar complex have been described in previous literature and have had success in securing good cosmetic outcomes. For patients with macrothelia, surgeons may employ a number of options in reducing nipple size.
View Article and Find Full Text PDFArch Clin Cases
December 2024
Division of General Surgery, McGill University, Montreal, Quebec, Canada.
Gigantomastia is a rare condition characterized by excessive breast enlargement, which can lead to physical and psychological distress. Gestational gigantomastia (GG) occurs during pregnancy, often presenting significant management challenges. This case contributes to the limited literature on GG management by highlighting the successful use of the Goldilocks technique combined with free nipple grafting, offering insights into an effective surgical approach.
View Article and Find Full Text PDFPlast Surg (Oakv)
March 2024
Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
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