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Mastectomy for Invasive Breast Cancer

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Breast Disease

Abstract

Although many patients currently treated for breast cancer will undergo breast conservation, there are instances in which mastectomy remains the procedure of choice. The mastectomy procedure has evolved considerably since the era of the radical mastectomy where the breast, pectoral muscles, axillary and infraclavicular lymph nodes were resected en bloc. Current techniques include the total mastectomy (non-skin-sparing), skin-sparing mastectomy, and nipple-areola-sparing mastectomy. The choice of mastectomy technique largely depends on the indication, tumor characteristics, and plans for reconstruction. This chapter reviews indications and patient selection for mastectomy and describes the technical aspects of current mastectomy techniques.

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Abbreviations

DCIS:

Ductal carcinoma in situ

NAC:

Nipple-areola complex

References

  1. Halsted WS. I. The results of operations for the cure of cancer of the breast performed at the Johns Hopkins hospital from June, 1889, to January, 1894. Ann Surg. 1894;20(5):497–555.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Meyer W. An improved method for the radical operation for carcinoma of the breast. Breast Med Rec. 1894;46:746.

    Google Scholar 

  3. Patey DH. A review of 146 cases of carcinoma of the breast operated on between 1930 and 1943. Br J Cancer. 1967;21(2):260–9. PubMed PMID: 6028079. Pubmed Central PMCID: 2008130. Epub 1967/06/01. eng.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Mc WR. The value of simple mastectomy and radiotherapy in the treatment of cancer of the breast. Br J Radiol. 1948;21(252):599–610. PubMed PMID: 18099752.

    Article  Google Scholar 

  5. Grace E. Simple mastectomy in cancer of the breast. Am J Surg. 1937;35:512.

    Article  Google Scholar 

  6. Madden JL, Kandalaft S, Bourque RA. Modified radical mastectomy. Ann Surg. 1972;175(5):624–34. PubMed PMID: 4555029. Pubmed Central PMCID: 1355229.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. Urban JA. Radical mastectomy with en bloc in continuity resection of the internal mammary lymph node chain. Am J Roentgenol Radium Ther Nucl Med. 1957;77(3):431–7. PubMed PMID: 13403036.

    CAS  PubMed  Google Scholar 

  8. Dahl-Iversen E, Tobiassen T. Radical mastectomy with parasternal and supraclavicular dissection for mammary carcinoma. Ann Surg. 1963;157:170–3. PubMed PMID: 14024626.

    CAS  PubMed  Google Scholar 

  9. Johansen H, Kaae S, Jensen MB, Mouridsen HT. Extended radical mastectomy versus simple mastectomy followed by radiotherapy in primary breast cancer. A fifty-year follow-up to the copenhagen breast cancer randomised study. Acta Oncol. 2008;47(4):633–8. PubMed PMID: 18465331.

    Article  PubMed  Google Scholar 

  10. Moxley 3rd JH, Allegra JC, Henney J, Muggia F. Treatment of primary breast cancer. Summary of the National Institutes of health consensus development conference. JAMA. 1980;244(8):797–800. PubMed PMID: 6893059. Epub 1980/08/22. eng.

    Article  PubMed  Google Scholar 

  11. Simone NL, Dan T, Shih J, Smith SL, Sciuto L, Lita E, et al. Twenty-five year results of the national cancer institute randomized breast conservation trial. Breast Cancer Res Treat. 2012;132(1):197–203. PubMed PMID: 22113254. Epub 2011/11/25. eng.

    Article  PubMed  Google Scholar 

  12. Fisher B, Jeong JH, Anderson S, Bryant J, Fisher ER, Wolmark N. Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation. N Engl J Med. 2002;347(8):567–75. PubMed PMID: 12192016. Epub 2002/08/23. eng.

    Article  PubMed  Google Scholar 

  13. Showalter SL, Grover S, Sharma S, Lin L, Czerniecki BJ. Factors influencing surgical and adjuvant therapy in stage I breast cancer: a SEER 18 database analysis. Ann Surg Oncol. 2013;20(4):1287–94. PubMed PMID: 23135311.

    Article  PubMed  Google Scholar 

  14. Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347(16):1227–32. PubMed PMID: 12393819. Epub 2002/10/24. eng.

    Article  PubMed  Google Scholar 

  15. Gentilini O, Botteri E, Rotmensz N, Da Lima L, Caliskan M, Garcia-Etienne CA, et al. Conservative surgery in patients with multifocal/multicentric breast cancer. Breast Cancer Res Treat. 2009;113(3):577–83. PubMed PMID: 18330695. Epub 2008/03/12. eng.

    Article  PubMed  Google Scholar 

  16. Lim W, Park EH, Choi SL, Seo JY, Kim HJ, Chang MA, et al. Breast conserving surgery for multifocal breast cancer. Ann Surg. 2009;249(1):87–90. PubMed PMID: 19106681. Epub 2008/12/25. eng.

    Article  PubMed  Google Scholar 

  17. Bauman L, Barth RJ, Rosenkranz KM. Breast conservation in women with multifocal-multicentric breast cancer: is it feasible? Ann Surg Oncol. 2010;17 Suppl 3:325–9. PubMed PMID: 20853054. Epub 2010/10/01. eng.

    Article  PubMed  Google Scholar 

  18. Toth BA, Lappert P. Modified skin incisions for mastectomy: the need for plastic surgical input in preoperative planning. Plast Reconstr Surg. 1991;87(6):1048–53. PubMed PMID: 1852020. Epub 1991/06/01. eng.

    Article  CAS  PubMed  Google Scholar 

  19. Freeman BS. Subcutaneous mastectomy for benign breast lesions with immediate or delayed prosthetic replacement. Plast Reconstr Surg Transplant Bull. 1962;30:676–82. PubMed PMID: 13959443. Epub 1962/12/01. eng.

    Article  CAS  PubMed  Google Scholar 

  20. Laronga C, Kemp B, Johnston D, Robb GL, Singletary SE. The incidence of occult nipple-areola complex involvement in breast cancer patients receiving a skin-sparing mastectomy. Ann Surg Oncol. 1999;6(6):609–13. PubMed PMID: 10493632. Epub 1999/09/24. eng.

    Article  CAS  PubMed  Google Scholar 

  21. de Alcantara FP, Capko D, Barry JM, Morrow M, Pusic A, Sacchini VS. Nipple-sparing mastectomy for breast cancer and risk-reducing surgery: the memorial sloan-kettering cancer center experience. Ann Surg Oncol. 2011;18(11):3117–22. PubMed PMID: 21847697. Epub 2011/08/19. eng.

    Article  Google Scholar 

  22. Crowe Jr JP, Kim JA, Yetman R, Banbury J, Patrick RJ, Baynes D. Nipple-sparing mastectomy: technique and results of 54 procedures. Arch Surg. 2004;139(2):148–50. PubMed PMID: 14769571. Epub 2004/02/11. eng.

    Article  PubMed  Google Scholar 

  23. Babiera G, Simmons R. Nipple-areolar complex-sparing mastectomy: feasibility, patient selection, and technique. Ann Surg Oncol. 2010;17 Suppl 3:245–8. PubMed PMID: 20853041. Epub 2010/10/01. eng.

    Article  PubMed  Google Scholar 

  24. Simmons RM, Brennan M, Christos P, King V, Osborne M. Analysis of nipple/areolar involvement with mastectomy: can the areola be preserved? Ann Surg Oncol. 2002;9(2):165–8. PubMed PMID: 11888874. Epub 2002/03/13. eng.

    Article  PubMed  Google Scholar 

  25. Winther Lietzen L, Cronin-Fenton D, Garne JP, Kroman N, Silliman R, Lash TL. Predictors of re-operation due to post-surgical bleeding in breast cancer patients: a Danish population-based cohort study. Eur J Surg Oncol. 2012;38(5):407–12. PubMed PMID: 22429495. Epub 2012/03/21. eng.

    Article  CAS  PubMed  Google Scholar 

  26. Agrawal A, Ayantunde AA, Cheung KL. Concepts of seroma formation and prevention in breast cancer surgery. ANZ J Surg. 2006;76(12):1088–95.

    Article  PubMed  Google Scholar 

  27. Budd DC, Cochran RC, Sturtz DL, Fouty Jr WJ. Surgical morbidity after mastectomy operations. Am J Surg. 1978;135(2):218–20. PubMed PMID: 626296. Epub 1978/02/01. eng.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Tracy-Ann Moo MD .

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Moo, TA., Simmons, R.M. (2015). Mastectomy for Invasive Breast Cancer. In: Riker, A. (eds) Breast Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1145-5_14

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  • DOI: https://doi.org/10.1007/978-1-4939-1145-5_14

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