The "Type V" skin-sparing mastectomy for upper quadrant skin resections

Area of Science:

• Oncology
• Plastic Surgery
• Breast Surgery

Background:

• Skin-sparing mastectomies (SSMs) are classified by incision type and breast size.
• Standard SSM techniques are often unsuitable for large breasts with superficial upper quadrant tumors due to interference with skin flap design.
• This limitation previously excluded certain patients from breast-conserving oncoplastic surgery.

Purpose of the Study:

• To present a modified Wise-pattern skin-sparing mastectomy (SSM type V) technique.
• To enable immediate breast reconstruction in patients with large breasts and upper quadrant tumors.
• To achieve natural breast aesthetics in a previously excluded patient group.

Main Methods:

• A modified Wise-pattern incision was employed for skin-sparing mastectomy (SSM type V).
• Mastectomy involved resection of upper quadrant skin with tumor, replaced by tissue from the lower pole.
• Twenty-four patients with varying tumor locations in the upper quadrants underwent the procedure with immediate reconstruction.

Main Results:

• No local or distant tumor recurrences were observed during a mean follow-up of 27 months.
• Excellent aesthetic outcomes were achieved, with natural breast shape restored in all patients.
• The modified SSM type V technique successfully addressed the limitations of previous methods for this patient cohort.

Conclusions:

• The modified Wise-pattern skin-sparing mastectomy (SSM type V) is a viable and effective oncoplastic technique.
• It allows for successful immediate breast reconstruction with natural shape in large-breasted patients with upper quadrant tumors.
• This procedure expands the applicability of breast-conserving surgery to patients previously considered ineligible.