I just read an article that said a lot of board-certified surgeons in CA reported they are still using traditional techniques for mastectomy, cutting across the whole breast and leaving unnecessary scars.
Why would surgeons do that instead of using skin-sparing mastectomy technique? Is there any reason that would justify not performing a skin-sparing mastectomy in favor of a traditional (and disfiguring) mastectomy?
Skin sparing mastectomies can be performed in many situations. Some situtations where you would not use this technique would be in patients with larger tumors close to the skin, and also in patients that have very ptotic (sagging) breasts.
Skin sparing mastectomies are a great advancement for breast cancer surgery. An extension of these is the nipple/areolar sparing mastectomy which give great results in the right patients. However, all breast cancers are not the same. Skin sparing mastectomy is best for small cancers that are not close to the skin. However, more severe cancers that are large or close to the skin, may require traditional modified mastectomy incisions. It is unclear from the report that you site whether the surgeons they surveyed perform traditional mastectomy some of the time or all of the time. I think that this clarification is important, since if you need a traditional mastectomy and the surgeon does not perform them, then you are not better off. It is important that you research all of your options before undergoing any surgery. Also, I would hope that most surgeons have your best interest at heart. It would be devastating if your cancer returned because an inadequate tissue (skin) resection was performed.
I hope this helps.
David Shafer, MD
Shafer Plastic Surgery - Manhattan
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