The recent damning report by lawyer Sir Ian Kennedy into breast-cancer surgery carried out by surgeon Ian Patterson at Solihull Hospital has highlighted the risks involved in the controversial ‘cleavage-sparing’ mastectomy procedure.
Leading Breast Cancer Surgeon Professor Kefah Mokbel explains below how ‘cleavage-sparing’ mastectomy can leave women at risk of breast cancer recurring.
"The cleavage-preserving mastectomy technique refers to an incomplete form of mastectomy. A significant proportion of breast tissue is deliberately left behind by the surgeon in the inner aspect of the breast in order to give the patient breast cleavage. This appears to have occured even in women who were 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 radiotherapy to the residual breast tissue. Therefore, such patients require regular check-ups including mammography, ultrasound scans and/or MRI 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 have 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."
