Scientific paper
Technical considerations for prophylactic mastectomy in patients at high risk for breast cancer

https://doi.org/10.1016/0002-9610(91)91100-WGet rights and content

Abstract

A study of 5 patients and 10 mastectomy specimens was performed to identify the extent of surgery necessary to completely remove all breast tissue in patients having prophylactic mastectomies. A standard total mastectomy performed for breast cancer was shown to frequently leave breast tissue within the superficial pectoralis major muscle and the lower skin flap. Frozen section analysis of margins was found to be essential to clear the axillary extension of the breast and lower skin flap in particular. The value of more extensive surgery to remove all glandular elements of the breast in the high-risk patient remains to be demonstrated.

References (12)

  • LJ Humphrey

    Subcutaneous mastectomy is not a prophylaxis against carcinoma of the breast: opinion or knowledge?

    Am J Surg

    (1983)
  • RK Synderman

    Prophylactic mastectomy: pros and cons

    Cancer

    (1984)
  • CF Jackson et al.

    The effectiveness of prophylactic subcutaneous mastectomy in Sprague-Dawley rats induced with 7,12-demethylbenzanthracene

    Plast Reconstr Surg

    (1984)
  • DE Anderson

    Genetic study of breast cancer: identification of a high risk group

    Cancer

    (1974)
  • RE Harris et al.

    Familial breast cancer: risk to the contralateral breast

    J Natl Cancer Inst

    (1978)
  • DE Anderson

    A genetic study of human breast cancer

    J Natl Cancer Inst

    (1972)
There are more references available in the full text version of this article.

Cited by (65)

  • A multidisciplinary view of mastectomy and breast reconstruction: Understanding the challenges

    2021, Breast
    Citation Excerpt :

    Nowadays, the dorsal fascia is not routinely removed by all surgeons. Removal of the dorsal fascia with the breast tissue is done depending on the tumour location and degree of invasion close to or in the muscle, as it is a rare event that breast ducts or glandular tissue will be found beyond the dorsal fascia of the breast [49,50]. However, surgical protocols vary among centres or National guidelines, for example in Denmark, the dorsal fascia (but not the muscle) is removed in most cases.

  • Local recurrence, the augmented breast, and the contralateral breast

    2018, The Breast: Comprehensive Management of Benign and Malignant Diseases
  • First case of invasive breast cancer following prophylactic bilateral skin sparing mastectomy in a BRCA1 mutation carrier

    2009, European Journal of Surgical Oncology
    Citation Excerpt :

    The breast tissue extends laterally into the axillary tail, sometimes past the border of the latissimus dorsi muscle.16 By dissecting through the clavipectoral fascia, the edge of the breast tissue can be identified.17 Removal of the pectoral major fascia is also performed as breast tissue may penetrate into this muscle.

  • Local Recurrence, the Augmented Breast, and the Contralateral Breast

    2009, The Breast: Comprehensive Management of Benign and Malignant Diseases
  • Prevention of Breast Cancer

    2005, Breast Cancer
View all citing articles on Scopus
View full text