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Clinical Outcomes of Video-Assisted Skin-Sparing Partial Mastectomy for Breast Cancer and Immediate Reconstruction with Latissimus Dorsi Muscle Flap as Breast-Conserving Therapy

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Abstract

Background

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.

Methods

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.

Results

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.”

Conclusions

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.

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Conflicts of interest statement

The authors received no financial support for the present study and declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Endocrine, Breast Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamikyo-ku, Kyoto, 602-8566, Japan

    Hiroo Nakajima, Ikuya Fujiwara, Naruhiko Mizuta, Koichi Sakaguchi, Mahiro Ohashi, Asako Nishiyama, Yoshimi Umeda & Miho Ichida

  2. Translational Cancer Drug Development, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Ikuya Fujiwara

  3. Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry, Tokyo, Japan

    Junji Magae

Authors
  1. Hiroo Nakajima
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  2. Ikuya Fujiwara
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  3. Naruhiko Mizuta
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  4. Koichi Sakaguchi
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  5. Mahiro Ohashi
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  6. Asako Nishiyama
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  7. Yoshimi Umeda
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  9. Junji Magae
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Correspondence to Hiroo Nakajima.

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Nakajima, H., Fujiwara, I., Mizuta, N. et al. Clinical Outcomes of Video-Assisted Skin-Sparing Partial Mastectomy for Breast Cancer and Immediate Reconstruction with Latissimus Dorsi Muscle Flap as Breast-Conserving Therapy. World J Surg 34, 2197–2203 (2010). https://doi.org/10.1007/s00268-010-0607-0

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