Subcutaneous mastectomy. A review of 130 cases

Subcutaneous mastectomy (SCM) is discussed in connection with 130 such procedures performed on 108 patients. Seventy-nine malignant breast lesions and 51 benign breast lesions were operated on by this technique, which lies midway between conservative therapy and classical ablation. Conservation of the nipple-areola complex depends on the results of intraoperative biopsy; flaps are reduced when necessary. Breast volume is usually reconstituted using a prosthesis. Eleven of the 79 malignant breast lesions recurred locally (13.6%): generalization of postoperative irradiation thus seems justified, as in conservative therapy protocols. The 5-year survival rate of 83% is comparable to that of other treatment techniques for T1-T2 cancers. Cosmetic results have been improved, and the fact that SCM may give a better result than reconstruction after mastectomy must be kept in mind. However, the technique is only indicated for those cases which would otherwise be suitable for conservative surgery, were it not for the need to resect the gland because of a diffuse pathology.