A new study has reported that breast cancer recurrence rates do not differ significantly between skin-sparing mastectomy and conventional mastectomy patients, after adjusting for clinical breast cancer stage and age. Skin-sparing mastectomy involves the removal of the skin of the nipple, areola, and the original biopsy scar, while leaving the remainder of the breast skin. The breast tissue under the skin is removed through the opening created around the nipple. The remainder of the skin forms a pouch to accommodate a breast implant or reconstruction using the woman's own tissue from another part of the body such as the abdomen. Although the use of skin-sparing mastectomy is becoming more common for women undergoing immediate reconstruction, there is little information concerning locoregional (in the breast, chest wall, or lymph nodes) and distant recurrence rates after treatment.
The study included 1,810 patients with stage 0 to III breast cancer in one breast who underwent total mastectomy at the authors' center between 2000 and 2005. A total of 799 (44.1%) participants underwent skin-sparing mastectomy compared to 1,011 (55.9%) who underwent conventional mastectomy.
Women who underwent conventional mastectomy tended to be older (58.3 compared to 49.3 years) and were more likely to have stage IIB or III disease (53.0% compared to 31.8%) than women in the skin-sparing mastectomy group. In addition, significantly more women in the conventional mastectomy group received chemotherapy before their surgeries and radiation treatment afterwards. As of a median follow-up period of 53-months, 119 (6.6%) participants had been diagnosed with local (in breast), regional (chest wall or lymph nodes), or distant recurrences. These recurrence rates were not found to differ significantly between the skin-sparing mastectomy and conventional mastectomy groups. The authors conclude that skin-sparing mastectomy is an acceptable treatment option for patients who are candidates for immediate breast reconstruction.