Impact of skin-sparing mastectomy with immediate reconstruction and breast-sparing reconstruction with miniflaps on the outcomes of oncoplastic breast surgery

Br J Surg. 2003 Apr;90(4):433-9. doi: 10.1002/bjs.4060.

Abstract

Background: The aim of this study was to compare the outcomes of skin-sparing mastectomy (SSM) with immediate myocutaneous flap reconstruction and partial mastectomy with latissimus dorsi miniflap reconstruction (LDMF) for breast cancer.

Methods: Some 106 disease-free patients (57 SSM, 49 LDMF) who had breast reconstruction between 1991 and 1999 participated in this retrospective review. The mean duration of follow-up was 42 (range 6-102) months. Measured outcomes included surgical complications, functional disability, cosmetic result and psychological morbidity.

Results: SSM outcomes were less favourable than LDMF outcomes with regard to postoperative complications (14 versus 8 per cent), further surgical interventions (79 versus 12 per cent), nipple sensory loss (98 versus 2 per cent), restricted activities (73 versus 54 per cent) and cosmetic outcome by panel assessment. Anxiety about residual cancer and ease of breast self-examination were similar in both groups.

Conclusion: LDMF was associated with fewer adverse surgical and physical sequelae than SSM, without compromising local control or cosmetic outcome. Both operations were associated with low psychological morbidity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety / etiology
  • Breast Neoplasms / psychology
  • Breast Neoplasms / surgery*
  • Carcinoma in Situ / psychology
  • Carcinoma in Situ / surgery*
  • Carcinoma, Ductal, Breast / psychology
  • Carcinoma, Ductal, Breast / surgery*
  • Depression / etiology
  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Mammaplasty / methods*
  • Mastectomy, Segmental / methods*
  • Mastectomy, Subcutaneous / methods*
  • Middle Aged
  • Patient Satisfaction
  • Quality of Life
  • Retrospective Studies
  • Surgical Flaps*
  • Treatment Outcome