[One stage skin-sparing breast repair after mastectomy]

Breast-conserving therapy has become very popular in the past 20 years. This treatment is beneficial only for early stages of breast cancer. When breast-conserving therapy is not indicated, skin-sparing mastectomy with immediate breast reconstruction using silicone implants or autogenous tissue is the surgical method of choice. The authors have analyzed the results obtained at three hospitals of Moscow, Novosibirsk, and Tula. A total of 58 breast repairs, including 23 with silicone expanders, 35 with TRAM-flaps were performed by February 2000. They accomplished different designs of skin incisions in relation to the size and site of a tumor and to the shape of the breast. These groups comprised patients with breast cancer T1-2No-1Mo. The follow-up averaged 25.8 months (range 5-52 months). All the patients underwent combined and complex treatments. The median of overall survival was not not achieved. One patient died from dissemination. Two-year acturial survival was 86.8% (one local recurrence). The incidence of postoperative complications was 34.7% in the implant group and 14.2% in the TRAM-flap group.