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Maximising the preservation of previously irradiated native mammary skin by skin-banking of the autologous flap: Outcome after 33 skin-sparing or nipple-sparing salvage mastectomies

Published:December 01, 2022DOI:https://doi.org/10.1016/j.bjps.2022.11.062
      Total ‘salvage’ mastectomy may be indicated for local recurrence or second primary tumour in 3% of women within the first 5 years after breast conserving therapy including whole-breast irradiation (BCT),
      • Jo T.
      • Hur J.
      • Min K.
      • Kim E.K.
      • Han H.H.
      • Eom J.S
      Immediate breast reconstruction after salvage mastectomy: Case control outcome comparisons of DIEP flap and DTI reconstruction.
      or in 10% within 10 years.
      • Alperovich M.
      • Choi M.
      • Frey J.D.
      • Lee Z.H.
      • Levine J.P.
      • Saadeh P.B.
      • et al.
      Nipple-sparing mastectomy in patients with prior breast irradiation: Are patients at higher risk for reconstructive complications?.
      Although superior aesthetic results of breast reconstruction can in general be achieved with preservation of native mammary skin flaps,
      • Kovach S.J.
      • Georgiade G.S
      The "banked" TRAM: A method to insure mastectomy skin-flap survival.
      ,
      • Reichl H.
      • Hladik M.
      • Wechselberger G.
      Skin banking: Treatment option for native skin necrosis following skin-sparing mastectomy and previous breast irradiation.
      combined nipple-sparing or skin-sparing mastectomy ([N]SSM) and immediate autologous breast reconstruction (IABR) is often discouraged because of higher post-radiation complication rates,
      • Reichl H.
      • Hladik M.
      • Wechselberger G.
      Skin banking: Treatment option for native skin necrosis following skin-sparing mastectomy and previous breast irradiation.
      with mammary skin flap necrosis occurring in up to 27% of these women.
      • Jo T.
      • Hur J.
      • Min K.
      • Kim E.K.
      • Han H.H.
      • Eom J.S
      Immediate breast reconstruction after salvage mastectomy: Case control outcome comparisons of DIEP flap and DTI reconstruction.
      ,
      • Alperovich M.
      • Choi M.
      • Frey J.D.
      • Lee Z.H.
      • Levine J.P.
      • Saadeh P.B.
      • et al.
      Nipple-sparing mastectomy in patients with prior breast irradiation: Are patients at higher risk for reconstructive complications?.

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      References

        • Jo T.
        • Hur J.
        • Min K.
        • Kim E.K.
        • Han H.H.
        • Eom J.S
        Immediate breast reconstruction after salvage mastectomy: Case control outcome comparisons of DIEP flap and DTI reconstruction.
        J Plast Reconstr Aesthet Surg. 2021; 74: 1495-1502
        • Alperovich M.
        • Choi M.
        • Frey J.D.
        • Lee Z.H.
        • Levine J.P.
        • Saadeh P.B.
        • et al.
        Nipple-sparing mastectomy in patients with prior breast irradiation: Are patients at higher risk for reconstructive complications?.
        Plast Reconstr Surg. 2014; 134: 202e-206e
        • Kovach S.J.
        • Georgiade G.S
        The "banked" TRAM: A method to insure mastectomy skin-flap survival.
        Ann Plast Surg. 2006; 57: 366-369
        • Reichl H.
        • Hladik M.
        • Wechselberger G.
        Skin banking: Treatment option for native skin necrosis following skin-sparing mastectomy and previous breast irradiation.
        Microsurgery. 2011; 31: 314-317
        • Akintayo R.M.
        • Weinstein A.L.
        • Olorunnipa O.B.
        • Otterburn D.M.
        The price of aesthetics after nipple-sparring mastectomy: A cost-minimization analysis of skin banking with deep inferior epigastric perforator flap.
        Ann Plast Surg. 2020; 84: 300-306