Breast cancer recurrence ‘unaffected by skin-sparing mastectomy’
MedWire News: Among candidates for immediate breast reconstruction, skin-sparing mastectomy (SSM) is an acceptable treatment option, with similar local-regional recurrence rates as conventional mastectomy (CM), US study findings indicate.
SSM, which consists of total mastectomy with resection of the nipple-areola complex while preserving the native skin envelope to as great a degree as possible, has become more popular over the past decade.
Noting that there is little information on long-term, local-regional, and distant recurrence rates for the procedure, Kelly Hunt and colleagues from the University of Texas MD Anderson Cancer Center in Houston, Texas, examined data on 1810 patients with stage 0 to III unilateral breast cancer who underwent total mastectomy between 2000 and 2005.
The team reports in the journal Cancer that 44.1% of patients underwent SSM, while 55.9% had CM. CM patients were significantly older than SSM patients, at 58.3 years versus 49.3 years of age, and were significantly more likely to have stage IIB or III disease, at 53.0% versus 31.8%. Furthermore, CM patients were significantly more likely to receive neoadjuvant chemotherapy and adjuvant radiotherapy than SSM patients, at 29.6% versus 20.5% and 25.1% versus 11.6%, respectively.
In all, 6.6% of patients experienced local, regional, or systemic recurrences at a median follow-up of 53 months. There were no significant differences in recurrence rates between patients who underwent SSM and those who had CM.
The 5-year actuarial disease-free survival rate was also not significantly different between SSM and CM patients, at 95.2% and 92.7%, respectively, and was not affected by adjusting for clinical TNM stage and age.
The researchers say: "Our study showed that SSM does not pose a higher risk of local, regional, or systemic recurrences over CM."
They add: "Skin-sparing mastectomy should therefore be considered standard of care for the patients undergoing mastectomy when immediate reconstruction is used."
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By Liam Davenport