Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Surg Oncol. 2010 Jul 1;102(1):39-42. doi: 10.1002/jso.21573.
Skin sparing mastectomy (SSM) has been demonstrated as an oncologically safe procedure for early breast cancer in several studies. But few studies concerned the safety of SSM for patients with locally advanced breast cancer; therefore, its safety for these patients is less clear. The purpose of this study is to examine the oncological safety of SSM followed by immediate reconstruction for locally advanced breast cancer.
We retrospectively analyzed 897 breast cancer patients who underwent mastectomy for stage IIB (T3N0)-III between 1996 and 2005. Of 897, 87 underwent SSM (n = 73) or nipple sparing mastectomy (NSM, n = 14). We compared the local recurrence (LR) rate, disease-free survival (DFS) and overall survival (OS) for SSM group with conventional mastectomy group.
The 5-year DFS and OS of SSM group were not worse than those of CM group for all stages. LR rate was 3.0% (2/67) for IIB, 2.8% (1/36) for IIIA, 4.5% (1/22) for IIIC, and 5.0% (1/20) for T3 in SSM group. There was no difference in LR rates between SSM group and CM group for all stages.
Our study demonstrates that SSM followed by immediate reconstruction is oncologically safe for locally advanced breast cancer.
在多项研究中，保皮乳房切除术（SSM）已被证明是早期乳腺癌的一种具有良好肿瘤学安全性的手术方式。但针对局部晚期乳腺癌患者的 SSM 安全性，仅有少数研究涉及，因此，其安全性尚不明确。本研究旨在探讨 SSM 联合即刻重建术用于局部晚期乳腺癌的肿瘤学安全性。
我们回顾性分析了 1996 年至 2005 年间接受 IIB 期（T3N0）-III 期乳腺癌改良根治术的 897 例患者。其中 87 例行 SSM（n=73）或保留乳头的乳房切除术（NSM，n=14）。我们比较了 SSM 组与常规乳房切除术组的局部复发率（LR）、无病生存率（DFS）和总生存率（OS）。
在所有分期中，SSM 组的 5 年 DFS 和 OS 均不劣于 CM 组。IIB 期、IIIA 期、IIIC 期和 T3 期的 SSM 组 LR 率分别为 3.0%（2/67）、2.8%（1/36）、4.5%（1/22）和 5.0%（1/20）。在所有分期中，SSM 组的 LR 率与 CM 组之间无差异。
我们的研究表明，SSM 联合即刻重建术用于局部晚期乳腺癌具有良好的肿瘤学安全性。
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