Skin-Reducing Mastectomy and Implant Reconstruction: Long-Term Surgical, Oncological, and Patient-Reported Outcomes

Area of Science:

• Plastic Surgery
• Breast Reconstruction
• Oncology

Background:

• Skin-reducing mastectomy (SRM) is a technique for immediate breast reconstruction using implants in women with large, ptotic breasts.
• Evaluating surgical and patient-reported outcomes (PRO) is crucial for understanding SRM's effectiveness.

Purpose of the Study:

• To assess the surgical outcomes of skin-reducing mastectomy (SRM).
• To evaluate patient-reported outcomes (PRO) following SRM using the BREAST-Q questionnaire.
• To analyze oncological outcomes and complication rates associated with SRM.

Main Methods:

• Retrospective analysis of patients undergoing SRM between January 2011 and December 2014.
• Collection of data on surgical complications, oncological outcomes, and PRO via BREAST-Q.
• Median follow-up of 10 years for long-term outcome assessment.

Main Results:

• 82.3% of 55 patients underwent SRM for cancer treatment; 83.6% had direct-to-implant reconstruction.
• Overall complication rate was 58.9%, with skin loss (24.2%) and capsular contracture (18.9%) being most common.
• At 10 years, local recurrence was 4.4%, overall survival 97.7%, disease-free survival 88.9%, with high patient satisfaction (76.5% would repeat SRM).

Conclusions:

• SRM facilitates immediate implant-based breast reconstruction in select patients with large breasts, potentially avoiding mesh use.
• While complication rates are notable, patient satisfaction with reconstructed breasts is high.
• SRM demonstrates favorable long-term oncological outcomes and high patient acceptance despite surgical challenges.