A 7 year experience with immediate breast reconstruction after skin sparing mastectomy for cancer

Skin sparing mastectomy (SSM) is a procedure that has gained popularity for patients who elect to have a mastectomy as the treatment for carcinoma of the breast. Reconstruction of the breast after SSM yields the best aesthetic results since it preserves most of the skin envelope and the inframammary fold. The purpose of this study was to evaluate the oncologic safety and aesthetic results for SSM and immediate breast reconstruction. One hundred and five patients treated between April 1997 and December 2004 were reviewed. The mean age of the patients was 40 years. The mean follow up was for 48 months, considered from the time of SSM and reconstruction. Reconstructive techniques included pedicled transverse rectus abdominis muscle (TRAM) flap (n: 70 patients), tissue expanders and implants (n: 29 patients), latissimus dorsi flaps and implants (n: 6 patients). Aesthetic results were judged by an independent plastic surgeon and by the patient as excellent, good, fair or poor. The findings of this study demonstrate that SSM and immediate breast reconstruction can be safely performed. Detection and treatment of recurrences were not inhibited by the reconstructions. In this experience the best results were seen after TRAM flap reconstructions. The general level of satisfaction expressed by the patient was correlated with a good appearance of the reconstructed breast and the physical comfort.