Prophylactic subcutaneous total glandectomy for mammary cystic disease, with immediate primary breast reconstruction.

Seventeen whole-breast tissue specimens of mammary cystic disease were prepared using Marcum's whole-mounting technique. Histological studies were performed on from 10 to 19 slides of tissue containing the suspected pathological foci. Cysts in the cleared breast tissues were numerous, and cyst walls were covered by single-layered duct epithelial cells with some apocrine metaplasia. The most notable findings were frequent minute carcinomatous foci next to the scattering of mammary cysts. The incidence of carcinoma among 17 mammary cystic disease patients was 8, or 47%. Each patient had from one to six minute carcinomatous foci--less than 1 mm in diameter and noninfiltrating. All patients were treated by subcutaneous total mastectomy and immediate breast reconstruction with the Natural-Y mammary prosthesis. In all 17 the results were good. With no hazardous complications. Steps toward immediate breast reconstruction are as imperative psychologically as the total glandectomy is clinically.