Clinical Outcomes of Video-Assisted Skin-Sparing Partial Mastectomy for Breast Cancer and Immediate Reconstruction with Latissimus Dorsi Muscle Flap as Breast-Conserving Therapy
- 255 Downloads
Skin-sparing partial mastectomy (SSPM) has yet to be investigated as a breast-conserving therapy for early-stage breast cancer. We report the clinical outcomes for video-assisted SSPM (VA-SSPM) with immediate breast reconstruction using autogenous tissue.
VA-SSPM is indicated for early-stage breast cancer arising in the upper-outer or lower-outer quadrant without skin involvement. An incision is placed along the midaxillary line, and SSPM is performed under endoscopic guidance using subcutaneous tunneling and lifting methods. Through the same incision, a latissimus dorsi muscle flap is harvested for breast reconstruction. From January 2000 to October 2007, 168 patients (Tis, n = 24; T1, n = 37; T2, n = 107) underwent VA-SSPM, and morbidity, curability, and postoperative patient satisfaction were investigated.
Postoperative complications included skin necrosis (2.4%, n = 4) and muscle flap necrosis (0.6%, n = 1), but no severe complications were observed. After a mean follow-up of 58.6 months, eight patients (4.8%) experienced local recurrence. Sixty-month distant metastasis-free survival rates for Tis, T1, and T2 were 100%, 97%, and 83.3%, respectively, with an overall rate of 88.4%. Furthermore, overall survival rates for Tis, T1, and T2 were 100%, 94.1%, and 94.4%, respectively, with an overall survival rate of 95% for all patients. A patient satisfaction survey showed that 81.6% of patients evaluated the surgery as “good.”
VA-SSPM for early-stage breast cancer improves cosmetic results and achieves high patient satisfaction without increasing local or distant organ recurrence. This method offers a useful local therapy for early-stage breast cancer.
KeywordsMammary Gland Sentinel Lymph Node Biopsy Partial Mastectomy Transverse Rectus Abdominis Myocutaneous Endoscopic Guidance
Conflicts of interest statement
The authors received no financial support for the present study and declare no conflicts of interest.
- 27.Goldhirsch A, Glick JH, Gelber RD et al., Panel members (2005) Meeting highlights: international expert consensus on the primary therapy of early breast cancer. Ann Oncol 16:1569–1583Google Scholar
- 28.NCCN Clinical Practice Guidelines in Oncology Breast Cancer v.2 (2008) http://www.nccn.org/professionals/physician_gls/PDF/breast.pdf. Accessed 1 May 2008