Skin-Sparing Total Mastectomy

Abstract

Indications • Ductal carcinoma in situ (DCIS) not amenable to breast conservation or patient requesting mastectomy, to be followed with reconstruction • Breast cancer treatment in selected patients, to be followed with reconstruction • Prophylaxis of carcinoma in select high-risk patients, to be followed with reconstruction Essential Steps 1. Confirm side of surgery. 2. Sentinel lymph node (SLN) biopsy if indicated for staging of the axilla. 3. Circumareolar skin incision or incision tailored to geometry of tumor. 4. Develop skin flaps. 5. Dissect breast from chest wall. 6. Hemostasis. 7. Orient specimen for pathology. 8. Irrigate and pack wounds for hemostasis prior to reconstruction.