Oncological safety of skin sparing mastectomy followed by immediate reconstruction for locally advanced breast cancer

Background and Objectives: Skin sparing mastectomy (SSM) has been demonstrated as an oncologically safe procedure for early breast cancer in several studies. But few studies concerned the safety of SSM for patients with locally advanced breast cancer; therefore, its safety for these patients is less clear. The purpose of this study is to examine the oncological safety of SSM followed by immediate reconstruction for locally advanced breast cancer. Methods: We retrospectively analyzed 897 breast cancer patients who underwent mastectomy for stage IIB (T3N0)-III between 1996 and 2005. Of 897, 87 underwent SSM (n=73) or nipple sparing mastectomy (NSM, n=14). We compared the local recurrence (LR) rate, disease-free survival (DFS) and overall survival (OS) for SSM group with conventional mastectomy group. Results: The 5-year DFS and OS of SSM group were not worse than those of CM group for all stages. LR rate was 3.0% (2/67) for IIB, 2.8% (1/36) for IIIA, 4.5% (1/22) for IIIC, and 5.0% (1/20) for T3 in SSM group. There was no difference in LR rates between SSM group and CM group for all stages. Conclusions: Our study demonstrates that SSM followed by immediate reconstruction is oncologically safe for locally advanced breast cancer.