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Mastectomy: Reconstructive Considerations and Strategies

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Breast Cancer Management for Surgeons

Abstract

In the modern era of multidisciplinary breast cancer management, breast conserving surgery has been established as the standard of care for early-stage disease when feasible to achieve oncological adequate margins and maintain the breast aesthetic. Despite advances in oncoplastic techniques and the increasing use of neoadjuvant systemic therapies that may broaden the scope of breast conservation, mastectomy is still playing an important role in breast surgery. This role includes not only the management of breast cancer, but also risk-reduction in women with high-risk predisposition genes. Currently, indications for mastectomy include inability or contraindication for adjuvant breast radiotherapy, lesions with high anticipated resection ratio and inflammatory breast cancer.

Mastectomy involves the removal of the entirety of the breast glandular tissue. This can be performed as a “simple” procedure also excising most of the overlying skin or with varying extent of skin preservation. With the evolution of surgical techniques, skin and nipple-sparing mastectomy have gained popularity and are now considered standard of care when oncologically appropriate. This approach facilitates immediate breast reconstruction, as it allows utilization of the preserved skin envelope to maximum benefit. The aim of this chapter is to provide an overview of the surgical techniques employed to perform a mastectomy and the reconstructive options following this procedure.

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Further Reading

  • Andersen ES, Weintraub C, Reuter Muñoz KD, et al. The impact of preoperative breast volume on development of mastectomy skin flap necrosis in immediate breast reconstruction. Ann Plast Surg. 2022;88:S403–9.

    Google Scholar 

  • Cohen WA, Ballard TNS, Hamill JB, et al. Understanding and optimizing the patient experience in breast reconstruction. Ann Plast Surg. 2016;77:237–41.

    Google Scholar 

  • Mitchell SD, Willey SC, Beitsch P, Feldman S. Evidence based outcomes of the American Society of Breast Surgeons Nipple Sparing Mastectomy Registry. Gland Surg. 2018;7:247–57.

    Google Scholar 

  • Nahabedian MY. Implant-based breast reconstruction: strategies to achieve optimal outcomes and minimize complications. J Surg Oncol. 2016;113:895–905.

    Google Scholar 

  • Nava MB, Catanuto G, Rocco N. Hybrid breast reconstruction. Minerva Surg. 2018:73.

    Google Scholar 

  • Nava M, Quattrone P, Riggio E. Focus on the breast fascial system: a new approach for inframammary fold reconstruction. PlastReconstr Surg. 1998;102:1034–45.

    Google Scholar 

  • Orzalesi L, Casella D, Santi C, et al. Nipple sparing mastectomy: surgical and oncological outcomes from a national multicentric registry with 913 patients (1006 cases) over a six year period. Breast. 2016;25:75–81.

    Google Scholar 

  • Rancati A, Angrigiani C, Hammond D, et al. Preoperative digital mammography imaging in conservative mastectomy and immediate reconstruction. Gland Surg. 2016;5:9–14.

    Google Scholar 

  • Rocco N, Gloria A, De Santis R, et al. Improving outcomes in breast reconstruction: from implant-based techniques towards tissue regeneration. Procedia CIRP. 2016;49:23–7.

    Google Scholar 

  • Salibian AA, Frey JD, Bekisz JM, et al. Ischemic complications after nipple-sparing mastectomy: predictors of reconstructive failure in implant-based reconstruction and implications for decision-making. PlastReconstr Surg - Glob Open. 2019;7:E2280.

    Google Scholar 

  • Weber WP, Haug M, Kurzeder C, et al. Oncoplastic breast consortium consensus conference on nipple-sparing mastectomy. Breast Cancer Res Treat Springer US. 2018;172:523–37.

    Google Scholar 

  • Zhou Y, Wang J, Li H, et al. Efficacy and Safety of Cell-Assisted Lipotransfer. PlastReconstr Surg. 2016;137:44e–57e.

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Correspondence to Marios-Konstantinos Tasoulis .

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Tasoulis, MK., Charalampoudis, P., Ghilli, M., Rocco, N., Catanuto, G. (2023). Mastectomy: Reconstructive Considerations and Strategies. In: Markopoulos, C., Karakatsanis, A. (eds) Breast Cancer Management for Surgeons. Springer, Cham. https://doi.org/10.1007/978-3-031-37752-5_8

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  • DOI: https://doi.org/10.1007/978-3-031-37752-5_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-37751-8

  • Online ISBN: 978-3-031-37752-5

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