What is Skin Sparing Mastectomy?
Skin sparing mastectomy (SSM) is a surgical technique used in the treatment of
breast cancer. During this procedure, most of the breast skin is preserved except for the nipple and areola. The goal is to remove the breast tissue while maintaining enough skin to cover a
breast reconstruction, which can often be performed at the same time as the mastectomy.
Who is a Candidate for Skin Sparing Mastectomy?
Not all patients are suitable candidates for skin sparing mastectomy. Ideal candidates typically include those with early-stage breast cancer,
ductal carcinoma in situ (DCIS), or those undergoing prophylactic mastectomy due to high genetic risk (such as BRCA1 or BRCA2 mutations). Patients with skin involvement by the cancer, inflammatory breast cancer, or certain other conditions may not be eligible for SSM.
What are the Benefits of Skin Sparing Mastectomy?
The primary benefit of skin sparing mastectomy is the improved aesthetic outcome. By preserving most of the breast skin, the reconstructed breast can have a more natural appearance. Additionally, SSM can often be performed in conjunction with immediate breast reconstruction, which reduces the number of surgeries and anesthesia events a patient must undergo.
What are the Risks Associated with Skin Sparing Mastectomy?
Like all surgical procedures, skin sparing mastectomy carries certain risks. These can include
infection, bleeding, and complications related to anesthesia. There is also a risk of leaving behind residual breast tissue that could potentially harbor cancer cells. However, studies have shown that the oncologic outcomes of SSM are comparable to those of traditional mastectomy when performed in appropriately selected patients.
How is Skin Sparing Mastectomy Performed?
During a skin sparing mastectomy, the surgeon makes an incision around the nipple and areola, which are then removed along with the underlying breast tissue. The remaining skin envelope is preserved, and the chest wall is prepared for immediate reconstruction. Techniques for reconstruction can vary, including the use of
tissue expanders, implants, or autologous tissue flaps such as the
DIEP flap or
TRAM flap.
What is the Recovery Process Like?
Recovery from skin sparing mastectomy varies depending on the individual and the type of reconstruction performed. Generally, patients can expect a hospital stay of 1-2 days. Pain and discomfort are managed with medication, and most patients can return to normal activities within 4-6 weeks. Follow-up care will include monitoring for any signs of complications and ensuring that the reconstruction is healing properly.
Are There Long-Term Considerations?
Long-term considerations for patients who undergo skin sparing mastectomy include regular follow-up appointments to monitor for any signs of
recurrence of breast cancer. Patients should also be aware of the potential need for additional surgeries, either for further cancer treatment or to refine the reconstruction. Psychological support and counseling may also be beneficial as patients adjust to their new body image.
Conclusion
Skin sparing mastectomy offers an effective treatment option for selected breast cancer patients, combining oncologic safety with improved cosmetic outcomes. As with any medical procedure, it is essential for patients to discuss their specific case with their healthcare team to determine the best treatment approach for their individual needs.
