Annals of Surgical Oncology

, Volume 10, Issue 2, pp 102–107

Skin Involvement in Invasive Breast Carcinoma: Safety of Skin-Sparing Mastectomy

  • Chiu M. Ho
  • Colin K. L. Mak
  • Yvonne Lau
  • Wing Y. Cheung
  • Miranda C. M. Chan
  • Wai K. Hung
Original Articles

DOI: 10.1245/ASO.2003.05.001

Cite this article as:
Ho, C.M., Mak, C.K.L., Lau, Y. et al. Ann Surg Oncol (2003) 10: 102. doi:10.1245/ASO.2003.05.001

Abstract

Background:There is concern about the oncological safety of preserving most of the breast skin in skin-sparing mastectomy (SSM). Most supportive evidence for SSM evaluates the local recurrence rate on clinical follow-up.

Methods:The skin and 10 mm of the subcutaneous tissue of 30 total mastectomy specimens were studied with a step-serial sectioning technique. The incidence and mode of involvement of the skin and subcutaneous tissue were recorded in detail. This was correlated with other clinical and pathologic parameters.

Results:The incidence of skin involvement outside the nipple-areola complex was 20% (6 of 30). This was significantly related to the clinical T stage, site of the tumor, skin tethering, pathologic tumor size, and perineural infiltration. When the effects of both skin and subcutaneous tissue involvement were considered, the incidence of skin-flap involvement outside the nipple-areola complex was 23% (7 of 30). The significant parameters related to skin-flap involvement were skin tethering (75% vs. 15%; P < .05), pathologic tumor size (P < .03), and perineural infiltration (63% vs. 9%; P < .01).

Conclusions:It would be oncologically safe to perform SSM in T1 and T2 tumors, because the chance of skin involvement is small. It is safe to preserve the skin overlying the tumor if there is no skin tethering.

Key Words:

Skin involvementInvasive breast carcinomaSkin-sparing mastectomySafety

Copyright information

© The Society of Surgical Oncology, Inc. 2003

Authors and Affiliations

  • Chiu M. Ho
    • 1
    • 4
  • Colin K. L. Mak
    • 3
  • Yvonne Lau
    • 2
  • Wing Y. Cheung
    • 1
  • Miranda C. M. Chan
    • 2
  • Wai K. Hung
    • 2
  1. 1.Department of Surgery, Division of Plastic Surgery (CMH, WYC)Kwong Wah HospitalHong Kong SARChina
  2. 2.Department of Breast Center (YL, MCMC, WKH)Kwong Wah HospitalHong Kong SARChina
  3. 3.Department of Pathology (CKLM)Kwong Wah HospitalHong Kong SARChina
  4. 4.Division of Plastic Surgery, Department of SurgeryKwong Wah HospitalHong Kong SARChina