Tag Archives: breast reduction

Skin Sparing Mastectomy

What is skin sparing mastectomy?

Removal of breast tissue via a surgical technique which preserves as much of the breast skin as possible.  Skin sparking mastectomy can be done as a simple, total, or a modified radical mastectomy.  The goal is to preserve the skin needed for immediate reconstruction by a plastic surgeon.

What is removed during a skin sparing mastectomy?

Nipple, areola and the original biopsy scar is removed during a skin sparing mastectomy.

Who can have skin sparing mastectomy?

Most women can have skin-sparing mastectomies however, it’s mainly done with the plan of having immediate breast reconstruction with your plastic surgeon.

When is it not safe to have a skin sparing mastectomy?

When there is risk of having skin involvement with breast cancer (such as with inflammatory breast cancer.

Recurrence rates of skin sparing mastectomy vs. winder skin removal

For early breast cancer the local recurrence rate is from 0-7% which is similar to those with wider skin removal mastectomies.

What is inflammatory breast cancer?

Inflammatory breast cancer, or IBC, is considered the most deadly form of breast cancer.  While some IBC patients have a lump, the majority of patients do not have a lump in the breast.  The cancer cells are in the lymph vessels blocking normal flow of lymph fluid thus there is swelling and skin dimpling associated.  There may be flattening and turning inward of the nipple or crusted changes.  Itching might be a symptom on the skin as well.

What is the difference between simple and total mastectomy?

Simple and Total mastectomy are synonymous.  This procedure involves removing the entire breast tissue without touching the axillary contents.

What is a modified radical mastectomy?

The entire breast tissue is surgically removed along with the axillary contents.  The pectoral muscles are untouched.

What is Early Stage Breast Cancer

Early stage breast cancer is breast cancer which has not spread beyond the breast to nearby axillary lymph nodes.  Ductal carcinoma in-sity, stage I, IIA, IIB, and IIIA breast cancer are included as early stage breast cancer.  The five year overall survival for women with stage I breast cancer is around 88 percent.

Stage I breast cancer

Stage I breast cancer involves a tumor size less than 2 cm.  No outside spread of breast cancer

Stage II breast cancer

Stage II breast cancer has a tumor more advanced than stage 1.  It has one of the following characteristics

  • Tumor is 2-5 cm in diameter.  +/- spread to axillary lymph nodes.
  • Tumor is >5 cm.  No spread.  (Stage IIA)
  • Tumor is <2 cm.  Positive for spread to no more than 3 axillary lymph nodes.  (Stage IIB)
  • No tumor found in the breast.  Positive for spread to no more than 3 axillary lymph nodes.

Stage III breast cancer

Stage III breast cancer is known as locally or regionally advanced breast cancer.  Some examples

  • Tumor is larger than 5 cm with positive spread to axillary lymph nodes, but the lymph nodes aren’t attached to each other.  Stage IIIA.
  • Tumor is smaller than 5 cm with positive spread of lymph nodes growing into each other and surrounding tissue.  Stage IIIA.
  • Tumor is smaller than 5 cm, but the cancer has spread to lymph nodes above the collar bone.  Stage IIIB.  Or tumor of anysize with fixation to skin or chest wall.
  • Inflammatory breast cancer is considered stage IIIB breast cancer.

Stage IV breast cancer = Metastatic breast cancer

Stage IV breast cancer is the most advanced form of breast cancer.  The cancer cells have spread to other areas of the body:   Lung, Liver, and Bone.

What is the T status for TNM staging of breast cancer?

T = tumor size.

  • T1 = less than 2 cm diameter for breast cancer
  • T2 = between 2-5cm

Smoking and flap necrosis with skin sparing mastectomies

Tissue flap necrosis is a possible complication related to a patient’s history of smoking as well as previous incisions for breast reduction.