Skin-Sparing Mastectomy and Immediate Breast Reconstruction

Renneker and Cutler, in a 1952 report, were the first to show that two psychological issues face breast cancer patients: anxiety due to the life-threatening nature of the illness and anxiety due to the disfigurement from surgical therapy.1 Quality of life has since become an important issue in the treatment of breast cancer patients, and efforts have been made to develop local therapy that is less disfiguring. Breast conservation therapy is an effort directed toward this end, and it has been well documented that survival after breast conservation therapy is the same as after modified radical mastectomy in patients with early-stage breast cancer.2,3 Despite this advance in therapy, many patients still require or choose modified radical mastectomy for their local therapy. In an effort to provide benefits similar to those of breast conservation therapy to patients who require or choose modified radical mastectomy, techniques have been developed that allow immediate breast reconstruction, which simulates the native breast in such a way that the psychological and emotional trauma from the modified radical mastectomy is negated and the quality of life of the patient is enhanced or maintained.