Clinical Outcomes of Patients Undergoing Skin-Reducing Mastectomies
Condition: Breast Cancer
MeSH terms: Breast Neoplasms
Study type: Observational [Patient Registry]

Summary: 
      The "mastectomy skin reducing" is a surgical procedure involving the removal of the mammary
      gland and, simultaneously, reducing the excess skin to enhance the aesthetic appearance in
      breast reconstruction. This technique is commonly used in patients with an excessive amount
      of residual skin after breast tissue removal, such as following a mastectomy for breast
      cancer treatment or prophylactic purposes (in patients at high risk of breast carcinoma due
      to family history and/or mutations in the Breast Cancers genes ).

      The goal of mastectomy skin reducing is to create a breast reconstruction that appears
      natural and aesthetically harmonious by minimizing excess skin. Excess skin can be removed in
      two main ways: as a conventional ellipse around the nipple-areola complex or, preferably, as
      part of an inverted "T"-shaped incision, commonly used in reduction mammoplasty. This
      procedure adheres to oncological principles of skin-conserving mastectomy and also
      incorporates a lower dermal flap, used to create a dermo-muscular pocket that reinforces the
      coverage of the prosthetic implant.

      The primary indication for mastectomy skin reducing is when a patient has excessively large
      (hypertrophic) and sagging (ptotic) breasts. In these cases, removing excess skin and breast
      tissue during mastectomy contributes to creating a solid foundation for breast reconstruction
      and improving the aesthetics of the reconstructed breast.

      The purpose of this retrospective study is to provide accurate data on the clinical outcomes
      of mastectomy skin reducing performed at the European Oncology Institute in Milan. This study
      is part of a larger project involving patients with breast cancer and/or carriers of
      mutations in the Breast Cancer genes who have undergone mastectomy skin reducing in the last
      5 years.
    

Detailed description: 
      It is a single-center study, conducted exclusively at the European Oncology Institute ( IEO).
      It is a retrospective study, analyzing events that occurred in the past. The results of this
      study, aggregating data from numerous patients, could influence public health policies by
      improving the efficiency and effectiveness of surgical treatments for patients with breast
      cancer and/or carriers of Breast Cancers mutations.

      The study is independent and non-profit, conducted by a group with no financial interests,
      and will collect, in addition to genetic data, clinical and pathological information (related
      to the disease), information on the types of treatments performed, the presence or absence of
      recurrences or other tumors, and the survival status of patients.

      IEO patient data will be transferred in anonymized form (the Oxford group cannot identify
      patients; only IEO can identify them) using a secure transmission channel. The study has been
      evaluated and authorized by an independent "Data Governance Board for Retrospective Studies
      at IEO" considering the scientific relevance of the study and its partners, relevance to the
      Institute's research lines, and the risk-benefit ratio from scientific, ethical-moral, and
      personal data protection perspectives.
    

Intervention name(s): skin reducing mastectomy
Intervention type(s): Procedure
Intervention description(s): The goal of mastectomy skin reducing is to create a breast reconstruction that appears natural and aesthetically harmonious by minimizing excess skin. Excess skin can be removed in two main ways: as a conventional ellipse around the nipple-areola complex or, preferably, as part of an inverted "T"-shaped incision, commonly used in reduction mammoplasty. This procedure adheres to oncological principles of skin-conserving mastectomy and also incorporates a lower dermal flap, used to create a dermo-muscular pocket that reinforces the coverage of the prosthetic implant.
This technique allows complete detachment of the pectoral muscle at the bottom while ensuring full coverage of the prosthetic implant with a dermo-muscular layer. By increasing the implant pocket and providing an additional tissue layer at the bottom of the breast, this technique can reduce the risk of complications and improve aesthetic outcomes.
Observational model: Other
Time perspective: Other
Sampling method: Non-Probability Sample
Study population: 
        breast cancer affected and/or High risk breast cancer ( BRCA1 and/or 2 mutated) women with
        moderate-large Brest underwent to skin reducing mastectomy.
      
Keywords: skin reducing mastectomy; breast cancer