Unité de chirurgie carcinologique et reconstructrice mammaire, Centre hospitalier Princesse-Grace, avenue Pasteur, 98000 Monaco, Monaco.
J Visc Surg. 2013 Nov;150(5):313-20. doi: 10.1016/j.jviscsurg.2013.09.011. Epub 2013 Oct 23.
Skin-sparing mastectomies (SSM) have gained acceptance among teams performing immediate breast reconstruction because this technique provides the best cosmetic outcome. Nevertheless, in France, concerns have been raised that limited skin excision during mastectomy could result in an increased risk of local recurrence especially in invasive breast cancer; many surgeons continue to have reservations regarding the oncologic safety of this operation. This is a retrospective, long-term follow-up study of 400 patients operated and followed by two oncoplastic surgeons.
A total of 400 patients with breast cancer underwent SSM with immediate breast reconstruction from January 1, 1992 to December 31, 2002. The American Joint Committee on Cancer pathological staging was Stage 0 (41.5%), Stage I (33.25%), Stage II (16%), Stage III (7.5%), while 1.75% were non-stageable.
With a mean follow-up period of 88 months (range: 13-215 months), the locoregional recurrence rate was 3.5%, the rate of distant metastases was 13.5%, and 83% of patients have remained free of recurrent disease.
This study provides encouraging results suggesting that skin-sparing mastectomy is a safe and reliable option for the management of selected cases of women with invasive or in situ breast cancer.
皮肤保留乳房切除术（SSM）在进行即刻乳房重建的团队中得到了认可，因为这种技术提供了最佳的美容效果。然而，在法国，人们担心在乳房切除术中有限的皮肤切除可能会增加局部复发的风险，尤其是在浸润性乳腺癌中；许多外科医生仍然对这种手术的肿瘤安全性持保留态度。这是一项回顾性的、长期随访研究，共纳入了两位肿瘤整形外科医生进行手术和随访的 400 名乳腺癌患者。
1992 年 1 月 1 日至 2002 年 12 月 31 日期间，共有 400 名乳腺癌患者接受了 SSM 加即刻乳房重建。美国癌症联合委员会的病理分期为 0 期（41.5%）、I 期（33.25%）、II 期（16%）、III 期（7.5%），而 1.75%的患者无法分期。
平均随访 88 个月（范围：13-215 个月），局部区域复发率为 3.5%，远处转移率为 13.5%，83%的患者无复发病例。
这项研究提供了令人鼓舞的结果，表明皮肤保留乳房切除术是治疗选择病例的浸润性或原位乳腺癌妇女的一种安全可靠的选择。
