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Why unconventional cleavage-sparing mastectomy is too risky

Posted Nov 14 2012 8:15am

Professor Kefah Mokbel , world-leading breast cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body. specialist explains how unconventional cleavage-sparing mastectomy can leave women at risk of the recurrence of cancer.

The cleavage preserving mastectomy mentioned in the recent media reports refers to an incomplete form of mastectomy, where a significant proportion of breast tissueA group of cells with a similar structure and a specialised function. is deliberately left by the surgeon in the inner aspect of the breast in order to give the patient breast cleavage, even in women not undergoing immediate reconstruction. Women who had this type of unorthodox mastectomy have an increased risk of breast cancer recurrence especially if they did not receive radiotherapyThe treatment of disease using radiation. to the residual breast tissue. Therefore, such patients require regular check-ups including mammographyA diagnostic and screening test using low-dose X-rays to detect breast tumours, ultrasound scans and/or MRIAn abbreviation for magnetic resonance imaging, a technique for imaging the body that uses electromagnetic waves and a strong magnetic field. to detect any recurrence at an early stage.

By contrast skin sparing mastectomy represents total mastectomy with the preservation of the skin envelope of the breast in order to optimise the aesthetic outcome of immediate reconstruction.

Skin sparing mastectomy is oncologically safe and represents the gold standard for women undergoing immediate reconstruction. In this type of mastectomy breast cleavage is maintained by preserving the skin envelop of the breast and replacing the breast tissue with an implant or a flap. Numerous studies have demonstrated that this type of mastectomy has an equivalent clinical outcome to non-sparing mastectomy. Therefore, those women who had a skin sparing mastectomy combined with immediate reconstruction have a similar risk of local recurrence to those who had a modified radical mastectomy.  The residual breast tissue left behind in skin sparing mastectomy and modified radical mastectomy is very tiny and is not associated with an increased risk of local recurrence. 

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