Risk of recurrence after treatment of early breast cancer with skin-sparing mastectomy

Background: Skin-sparing mastectomy, combined with immediate breast reconstruction, has become increasingly popular. However, there are no published long-term data to support its oncologic safety. Our purpose was to evaluate the long-term oncologic risk of skin-sparing mastectomy. Methods: The records of all patients who had undergone treatment of T1 or T2 breast cancer by mastectomy and immediate breast reconstruction, and who were followed for at least 5 years or developed recurrence of disease before that time were reviewed. Local and distant recurrence rates observed in patients treated by skin-sparing mastectomy were compared with those in patients treated by conventional, non-skin-sparing mastectomy. Results: A total of 104 patients were treated with skin-sparing mastectomies. In that group, 6.7% developed local recurrences, 12.5% developed distant metastases, 88.5% remained free of disease, and 7.7% died of their disease. Among the 27 patients who did not have skin-sparing mastectomies, 7.4% had local recurrences, 25.9% had distant metastases, 74.1% remained free of disease, and 18.5% died of disease. These recurrence rates are similar to those reported elsewhere after treatment with conventional mastectomy and without reconstruction. Conclusions: Our findings suggest that skin-sparing mastectomy does not significantly increase the risk of local or systemic disease recurrence in patients with early breast cancer.