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Chan, L.W., Rabban, J., Hwang, E.S., Bevan, A., Alvarado, M., Ewing, C., Esserman, L. and Fowble, B. (2011) Is Radiation Indicated in Patients with Ductal Carcinoma in Situ and Close or Positive Mastectomy Margins? International Journal of Radiation Oncology, Biology, Physics, 80, 25-30. http://dx.doi.org/10.1016/j.ijrobp.2010.01.044

has been cited by the following article:

• TITLE: Skin-Sparing Mastectomy and Breast Reconstruction: An Update for Clinical Practice

  AUTHORS: Abdul Kasem, Christina Choy, Kefah Mokbel

  KEYWORDS: Skin-Sparing Mastectomy; Breast Reconstruction

  JOURNAL NAME: Journal of Cancer Therapy, Vol.5 No.3, March 25, 2014

  ABSTRACT: Aim: To provide an up-to-date review of the literature on skin-sparing mastectomy (SSM) for breast cancer (BC). The article also reviews the oncological safety, effects of radiotherapy (RT) on immediate breast reconstruction (IBR), the indications for preserving the nipple-areola complex (NAC) and the emerging role of allogenic grafts as adjuncts to implant in IBR. Methods: Review of the English literature from 1965 to 2013 was carried out using Medline and PubMed research engines. Results: SSM is oncologically safe in appropriately selected cases of invasive breast cancer (IBC) and ductal carcinoma in-situ (DCIS) including IBC 5 cm, multi-centric tumours, DCIS and for risk-reduction surgery. Inflammatory breast cancer and tumours with extensive skin involvement represent contra-indications to SSM due to an unacceptable risk of local recurrence. Prior breast irradiation or the need for post-mastectomy radiotherapy (PMRT) do not preclude SSM with IBR, however the aesthetic outcome may be compromised by radiation. Preservation of the nipple-areola complex (NAC) has aesthetic and psychological benefits and is safe for peripherally located node negative unifocal tumours. An intraoperative frozen section protocol for the retro-areolar tissue should be performed when NAC preservation is considered. The advent of acellular dermal matrix has enhanced the scope of implant-based immediate reconstruction following SSM. Cell-assisted fat transfer is emerging as a promising technique to optimise the aesthetics outcome. There is no sufficient evidence to support the role of endoscopic mastectomy in clinical practice. Conclusion: Numerous retrospective and prospective studies show that SSM is oncolgically safe in appropriately selected cases and is aesthetically superior to non-SSM mastectomy. New tech-niques such as the use of acellular dermal matrix (ADM) and cell-assisted fat transfer have increased the use of implants for volume replacement following SSM. In the absence of randomized clinical trials, an updated systematic meta-analysis of published studies is required in order to consolidate the evidence.