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At least 19 recordsLinked to original sources
PubMed1985

[Problems and limits of mammographic cancer diagnosis. Comparison of preoperative radiologic diagnosis with histologic findings in 335 patients with subcutaneous mastectomy].

Subcutaneous mastectomy was performed in 335 patients between 1974 and 1982. In 265 of these, original mammographies were available which were analysed retrospectively and compared with the final histological finding of the subcutaneous mastectomy preparation. The rate of newly discovered non-invasive carcinomas in this was 11%, whereas the rate of invasive carcinomas was 8%. Radiological criteria: high degree of dysplasia, difficult assessment and mastopathy associated with large cysts, are associated with a significantly increased number of malignant histological findings. The radiological criteria of mastopathy, such as adenosis, fibrosis, indurating oedema of stroma, small-cyst mastopathy, as well as parenchymal patterns according to Wolfe, are not important with regard to our group of patients in respect of further selection of risk patients. Criteria of malignancy which are typical of carcinoma, are on the whole rarely recognised, because their assessment is often difficult. In patients with preceding carcinoma of the other breast, indication for subcutaneous mastectomy in case of "unclear" mammography has proved justified: In 4 out of 18 cases, a non-invasive or invasive carcinoma was found. Indication for primary subcutaneous mastectomy was too liberal in case mammography had been assessed as "benign", for the carcinoma rate was only 1/73. In radiologically "unclear" findings, the number of subsequently discovered non-invasive and invasive carcinomas was distinctly higher (in each case 6 out of 58). In such cases an attempt should be made to confirm preoperative diagnosis by means of additive measures before performing subcutaneous mastectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1997

Metastatic breast cancer 42 years after bilateral subcutaneous mastectomies.

Subcutaneous mastectomy has a possible role as prophylaxis in patients at high risk of developing breast cancer. A case history is presented of a woman who developed metastatic breast carcinoma 42 years after bilateral subcutaneous mastectomies for non-malignant disease. This case is presented to draw attention to the persistent risk of developing breast cancer even decades after subcutaneous mastectomy and to point out that the role of such surgery in preventing breast cancer has still not been clarified. The appropriateness of prophylactic mastectomy for an individual is better assessed on the absolute risk of breast cancer developing over a defined period rather than the relative risk.

Aged↗
PubMed1975

A 10-year experience with subcutaneous mastectomy.

Subcutaneous mastectomy appears to remain a procedure of promise. This 10-year experience indicated that it is feasible in at least 80 per cent of selected patients to successfully remove the breast parenchyma and subsequently reconstruct the breast without serious complications. It is resonable to assume that as surgical technique and experience improve, the complication rate will diminish. Furthermore, it is essential that better breast implants be devised and developed in the future. This would clearly enhance all forms of cosmetic breast surgery. The use of subcutaneous mastectomy as a prophylactic cancer procedure will parellel the improvement of implant breast reconstruction. Whether subcutaneous mastectomy will measurably reduce the mortality rate of carcinoma of the breast will, of course, take a generation to determine. However, I have no doubts that is it as justifiable and valuable surgical tool in the treatment of breast disease. The concept of almost total breast biopsy has great merit in the discovery of occult carcinoma. Clearly, caution should be exercised in the selection of cases for this modality, and further study must be devoted to develop diagnostic guidelines of ever-increasing precision to determine which breasts are potentially malignant and should be afforded the procedure.

Adult↗
PubMed1982

Experience with 250 cases of subcutaneous mastectomy.

Subcutaneous mastectomy is a recognised form of curative treatment in cases of carcinoma lobulare in situ and of any atypical proliferative mastopathy. Moreover a subcutaneous mastectomy should be recommended for these patients when multiple biopsies have been performed and long-term mammographic supervision is no longer possible. By using all the existing skin and subcutaneous tissue a good aesthetic result can be achieved and prostheses should only be used in cases where the existing tissues cannot provide an adequate breast reconstruction. The operative technique developed by Schrudde is described and the results of 250 cases are presented.

Adult↗
PubMed1987

An improved technique for immediate retropectoral reconstruction after subcutaneous mastectomy.

Subcutaneous mastectomy is becoming an operation of choice in certain cases of premalignant and other breast pathology. We describe a technique for simultaneous subcutaneous mastectomy and retropectoral implantation of a silicone prosthesis. Gentle blunt prepectoral, retromammary dissection is performed through an axillary incision as far inferiorly as the inframammary fold, where a fibrous bridge between the anterior surface of the pectoralis major muscle and the skin prevents dissection any lower. Through the same incision, the retropectoral space is dissected to about 5 cm below the inframammary fold. A second incision is made in the inframammary fold to join the retromammary plane of the first dissection. The gland is then dissected subcutaneously and removed through the inframammary incision. A silicone implant is introduced retropectorally through the axillary incision, thus avoiding splitting the pectoralis major. Satisfactory results have been obtained in 23 bilateral and 14 unilateral cases; it is important that the dissection be performed carefully in order to prevent the implant from riding up too high in its musculoaponeurotic sling.

Breast↗
PubMed1981

Subcutaneous mastectomy.

Subcutaneous mastectomy is a compromise surgical procedure for the precancerous breast. We do not think that total mastectomy is indicated in such patients. The effect of the small cuff of tissue beneath the areola more than compensates for the minimal additional risk by leaving a more attractive and eminently more acceptable breast. In the past six years, in more than 150 patients, use of the fanned muscle flap has not only restored warmth and thickness to the thin breast envelope but provided additional suture-line protection. The layered closure has prevented implant exposure even with traumatic or seromatous skin separation on several occasions. Placement of the incision lateral to the areola or entirely above the areola prevents unnecessary visible scarring with most clothing and provides additional protection for the incision line since it overlies the muscle flap. With increasing experience using this procedure, we now attempt to limit all our incisions to the supraareolar hemicircle. Neither incision limits visualization of the axilla or of the inevitable bleeding in this area.

Female↗
PubMed1997

[Subcutaneous mastectomy].

The subcutaneous mastectomy (SM) which cannot be standardized is the possible treatment in a given indication especially to reduce the risk of cancer to a large extent-though only through experienced hands. Any re-operation often resulting from the complications of reconstructions through silicon prostheses can be more extensive than mamma-carcinoma therapy itself. The patient as well as the surgeon must be aware that the aesthetic result of the therapy is not the primary reason for the operation but the prevention or therapy of a life-threatening disease. With this perspective in mind the high rate of complications with SM is an acceptable risk and may ensure a high degree of permanent tumor removal.

Breast Implants↗
PubMed1978

Total glandular mastectomy. Modifications of the subcutaneous mastectomy for use in premalignant disease of the breast.

We describe two modifications of the original subcutaneous mastectomy, in which we remove the nipple en bloc with the breast, and we believe they are as suitable as other mastectomies for the removal of microcarcinomas and premalignant diseases of the breast. We do not advocate them for macroscopic malignancy. We are using the term "total glandular mastectomy" to designate these two modifications.

Breast Neoplasms↗
PubMed1979

[Subcutaneous mastectomy (author's transl)].

Subcutaneous mastectomy is a real precaution to third-order mastopathy, and it is urgently indicated for therapeutic action on carcinoma in situ, since the incidence of invasive carcinomas to accompany such diseases is between ten and 25 per cent. Proliferative forms of mastopathies were recorded from 768 in 2,563 surgically treated women, with atpical tissue being found in 164 cases. Carcinoma in situ was established from 28 women. Indications, limitations of the method, surgical technique, and complications are discussed against the background of results obtained from 31 subcutaneous mastectomies.

Adult↗
PubMedDate not supplied

[Modified subcutaneous mastectomy. Apropos of 916 cases].

Modified subcutaneous mastectomy was described by one of us in 1968; its approach, the dissection of the gland, plastic reconstruction of shape and volume are completely different from the subcutaneous mastectomy performed by plastic surgeons. 3 different time periods were studied to explain clearly evolution in the technic and indications. During many years retrospective studies made it possible to build a procedure according to the new diagnostic means for infraclinical breast cancer and to the constant improving prosthetic material. Therefore our indications for modified subcutaneous mastectomy are as following: suspicious mastopathies are the best indications with a performing choice of the radiologic images which require histologic control some evolutive or evoluated mastopathies some small infiltrating tumors developing in a highly dystrophic glandular surrounding. The numerous in situ cancers accompanying them argue for this choice. some big phyllod tumors or phyllod's recurrences.

Breast Implants↗
PubMedDate not supplied

A comparative study of subcutaneous mastectomy with radical mastectomy.

The purpose of this study was to compare the results of 133 cases (131 patients) of subcutaneous mastectomy with axillary dissection between 1983 and 1999 and 910 cases of radical mastectomy during the same period. The median follow-up period of the subcutaneous mastectomy group and the radical mastectomy group were 66 months and 81 months, respectively. The age at operation was significantly (p<0.01) younger in the subcutaneous mastectomy group than in the radical mastectomy group and the clinical stage was significantly (p<0.01) earlier. Lymph node metastasis was significantly (p<0.01) higher in the radical mastectomy than in the subcutaneous mastectomy group. There was no difference in ER status between the two groups. There was local recurrence in 5 (3.8%) members of the subcutaneous mastectomy group and in 12 (1.3%) members of the radical mastectomy group. There was no difference in disease-free survival and overall survival between the two groups. Divided into two subgroups by lymph node status, there was no difference in disease-free survival and overall survival between the two groups. Local recurrence occurred more frequently (p<0.05) in the subcutaneous mastectomy group, however, than in the radical mastectomy group when no lymph node metastasis was found. Multivariate analysis using the Cox hazard model showed that operation method and lymph node status were independent prognostic factors for local recurrence, whereas, lymph node status and ER status were independent prognostic factors of disease-free survival. In conclusion, subcutaneous mastectomy presents a risk factor for local recurrence, but the survival rate of the subcutaneous mastectomy group is as favourable as the radical mastectomy group.

Adult↗
PubMed1988

Surgical alternatives in subcutaneous mastectomy reconstruction.

The approach to subcutaneous mastectomy is presented, with emphasis on individualization of surgical technique. The operation is based on breast size as well as nipple-areolar complex location. Reconstructive alternatives include a mammary prosthesis, tissue expander, and autologous tissue.

Breast↗
PubMed1981

The curved lateral incision technique for subcutaneous mastectomy.

The inframammary incision often used for subcutaneous mastectomy provides somewhat limited exposure and often less than optimal aesthetic results, especially if the patient has ptosis preoperatively. This paper describes a technique for subcutaneous mastectomy that involves a straightforward marking system, provides excellent exposure, and produces satisfactory aesthetic results. This technique can be applied to most cases in which subcutaneous mastectomy is indicated.

Adult↗
PubMed2006

Breast reconstruction following subcutaneous mastectomy for cancer: a critical appraisal of the nipple-areola complex.

BACKGROUND: Subcutaneous mastectomy for women with advanced breast cancer has been historically controversial because of the increased risk for tumor recurrence. Despite this, some women remain interested in this method of treatment as a means of preserving the appearance of the breast and nipple-areola complex. Several studies have evaluated the feasibility of subcutaneous mastectomy; however, there has been no study that has critically analyzed the aesthetic outcome of the nipple-areola complex following this approach. METHODS: Over a 14-month interval, 12 women had subcutaneous mastectomy with preservation of the nipple-areola complex. The reconstruction was unilateral in 10 women and bilateral in two women, totaling 14 breasts. The mastectomy was for cancer in 11 and for prophylaxis in three breasts. Outcomes were assessed based on the sensation, appearance, and secondary procedures of the nipple-areola complex, and tumor recurrence and patient satisfaction. RESULTS: Of the five parameters, sensation was present in six breasts (42.9 percent), delayed healing was noted in four breasts (28.6 percent), symmetry with the contralateral breast was achieved in five of 10 women (50 percent) following unilateral reconstruction, tumor recurrence was noted in three of 11 breasts (27.3 percent), and secondary procedures related to the nipple-areola complex were necessary in five of the 14 breasts (35.7 percent). Outcome was graded as excellent in three, good in eight, and poor in three breasts. CONCLUSION: This study has demonstrated that aesthetic outcome of the nipple-areola complex is variable following subcutaneous mastectomy and immediate breast reconstruction. However, patient satisfaction was graded as good to excellent in 11 of 14 breasts (78.6 percent). Subcutaneous mastectomy with flap reconstruction results in fewer secondary procedures and improved aesthetic outcome when compared with implant reconstruction.

Adult↗
PubMedDate not supplied

Subcutaneous mastectomy with axillary dissection for early breast cancer.

From 1983 to 1990, subcutaneous mastectomy with axillary dissection was carried out for 46 patients with early breast cancer including three bilateral breast cancer patients (four breasts). Cancer cells were recognized histopathologically in the resection margins of small mammary gland resting under the nipple in four cases, and the remaining 42 cases underwent a curative resection. Multicentric lesions were found out histopathologically by continuous sections in five cases (six breasts). There was no difference in the prognosis using the case-control comparison method between 34 patients with ipsilateral invasive carcinoma who underwent a subcutaneous mastectomy in this study group and 34 patients who underwent a radical or modified radical mastectomy in the control group. Cosmetic results of the subcutaneous mastectomy were evaluated in 37 patients, and 9 were excellent, 17 were good, 9 were not so good and 2 were poor. Subcutaneous mastectomy with axillary dissection was an effective operation for early breast cancer including multicentric lesions and some non-invasive ductal carcinomas from the prognostic and cosmetic standpoints.

Adult↗
PubMed1987

Detailed technique of subcutaneous mastectomy with and without mastopexy.

Successful subcutaneous mastectomy without an unreasonable incidence of complications is achievable only with meticulous attention to detail. Detailed techniques of subcutaneous mastectomy with and without mastopexy and concomitant reconstruction with submuscular implants are described. Based on the results of the present study, the procedure, while not truly prophylactic, does reduce the risk of cancer.

Breast↗