[Progress in immediate breast reconstruction with skin sparing mastectomy]

Area of Science:

• Oncology
• Plastic Surgery
• Breast Surgery

Context:

• Skin sparing mastectomy (SSM) and subcutaneous mastectomy (SCM) are evolving surgical techniques for breast cancer treatment.
• These procedures are consistently linked with immediate breast reconstruction (IBR).
• There is ongoing discussion regarding the oncologic safety and appropriate indications for SSM and SCM.

Purpose:

• To evaluate the oncologic safety and indications for skin sparing mastectomy (SSM) and subcutaneous mastectomy (SCM) when combined with immediate breast reconstruction (IBR).
• To compare the oncologic outcomes of SSM and SCM with modified radical mastectomy.
• To assess the cosmetic benefits and patient selection criteria for SSM and IBR.

Summary:

• SSM and SCM, when correctly indicated, demonstrate oncologic safety comparable to modified radical mastectomy for early breast cancer, with numerous studies validating this.
• While overall survival cannot be determined from non-randomized studies, these techniques are validated in the oncologic setting with multidisciplinary decision-making.
• SSM with IBR offers superior cosmetic results and is ideally indicated for specific breast cancer types, particularly when postoperative radiotherapy is not required.

Impact:

• These findings support the validation of SSM and SCM with IBR as standardized oncologic procedures.
• The study highlights the importance of patient selection, especially regarding the need for postoperative radiotherapy, and suggests a two-step approach when preoperative criteria are uncertain.
• Improved organization of care through professional networks is crucial to ensure wider access to these validated breast cancer treatment options.