The most commonly performed operation for breast cancer has gradually changed in recent years from mastectomy to lumpectomy. There are still many cases, however, in which complete removal of the breast is a better choice for the patient. Progress in understanding the behavior of breast cancer and advances in plastic surgical reconstructive techniques have combined to produce better results from surgery, both in terms of successful outcome and cosmetic result. Skin sparing mastectomy is a recently developed surgical technique which allows removal of all of the breast breast tissue but leaves most of the overlying skin. This can be carried out without compromising the patient's chance for cure and provides a better situation for plastic surgical reconstruction, resulting in a nearly normal appearance following surgical treatment.

It was formerly believed that an adequate mastectomy involved removal of most of the skin overlying the breast tissue to avoid a high recurrence rate of the cancer. There is now good evidence that this is not true, and that even when small amounts of breast tissue are allowed to remain the risk of the cancer returning is not any greater than when a standard mastectomy is done.

Skin sparing mastectomy takes more time to perform than a standard mastectomy and great care is needed to preserve the blood supply to the remaining skin and avoid areas of skin ulceration as healing progresses. The nipple must still be removed because of the attachment of the main breast ducts to it, but plastic surgeons have very effective techniques for reconstructing the nipple, and having most of the other skin in place simplifies the reconstruction and leads to a better final cosmetic result. It is a delicate procedure which requires special training and skill, and is just becoming available at medical centers now. Several of our surgeons perform this operation.