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Omer Hospital
Wazir Habib Cancer Services, Canal Road (Opposite Doctors Hospital), Johar Town
Oncology MD Clinic, Jail Road

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Skin Sparing Mastectomy

Welcome to Lahore Oncoplastic Breast Services. I’m Dr. Hammad Raza Sheikh, and today we’re diving into the topic of Skin Sparing Mastectomy (SSM). This advanced surgical technique has revolutionized breast cancer treatment, offering hope and improved outcomes for many patients. Let’s explore this important topic together.

 

Understanding Skin Sparing Mastectomy: An Overview

Skin Sparing Mastectomy is a sophisticated surgical procedure used in breast cancer treatment. Unlike traditional mastectomy, which removes all breast tissue including most of the skin, SSM preserves much of the breast skin envelope. This technique allows for more natural-looking breast reconstruction, often in the same surgery.

The importance of SSM in breast cancer treatment cannot be overstated. It combines the oncological safety of mastectomy with improved cosmetic outcomes, significantly impacting patients’ quality of life and body image after breast cancer treatment.

 

Recent Advancements in Skin Sparing Mastectomy

The field of breast cancer surgery is continually evolving, and SSM has seen significant advancements in recent years. Here are some key developments:

  1. Nipple-Sparing Mastectomy (NSM): An extension of SSM that preserves the nipple-areola complex when oncologically safe.
  2. Robotic-Assisted Mastectomy: Enhances surgical precision and may reduce complications.
  3. Intraoperative Radiation Therapy (IORT): Allows for targeted radiation during surgery in selected cases.
  4. Advanced Imaging Techniques: Improves preoperative planning and intraoperative decision-making.
  5. Improved Reconstruction Techniques: Including prepectoral implant placement and autologous fat grafting.

In Pakistan, we’re working to incorporate these advancements into our healthcare system. While not all hospitals may have access to the latest technologies, specialized centers like ours are equipped to offer these advanced techniques.

 

Statistics on Skin Sparing Mastectomy in Pakistan

While comprehensive national statistics on SSM in Pakistan are limited, we can draw insights from available data and clinical experience:

– Breast Cancer Incidence: Breast cancer is the most common cancer among Pakistani women, with an age-standardized incidence rate of 43.9 per 100,000 women.

– SSM Adoption: The use of SSM has been increasing in Pakistan, with an estimated 30-40% of mastectomies now performed using skin-sparing techniques in major urban centers.

– Patient Demographics: Most SSM patients are between 35-60 years old, reflecting the age distribution of breast cancer in Pakistan.

– Success Rates: Studies show SSM has comparable oncological safety to traditional mastectomy, with local recurrence rates of 2-5% at 5 years.

– Reconstruction Rates: Immediate breast reconstruction following SSM is performed in approximately 60-70% of cases in specialized centers.

These figures can vary depending on factors such as healthcare access, awareness, and early detection rates.

 

Traditional vs. Advanced Techniques: A Comparison

Let’s compare the outcomes of traditional mastectomy with SSM:

 

Traditional Mastectomy:

– Removes all breast tissue and most skin

– Limited options for natural-looking reconstruction

– Longer recovery time (4-6 weeks on average)

– May require multiple surgeries for reconstruction

– Can result in significant chest wall deformity

 

Skin Sparing Mastectomy:

– Preserves breast skin envelope

– Allows for more natural-looking immediate reconstruction

– Faster recovery time (3-4 weeks on average)

– Often allows for single-stage reconstruction

– Improved cosmetic outcomes and body image

While traditional mastectomy may still be necessary in some cases, SSM offers significant benefits in terms of cosmetic outcomes and quality of life for suitable candidates.

 

Benefits for Pakistani Patients

SSM brings several benefits to patients in Pakistan:

  1. Improved cosmetic outcomes, boosting self-esteem and body image
  2. Faster recovery times, allowing quicker return to daily activities
  3. Reduced need for multiple surgeries
  4. Psychological benefits of waking up from surgery with a reconstructed breast
  5. Potential for nipple preservation in appropriate cases
  6. Comparable oncological safety to traditional mastectomy

For many women, these benefits can make a significant difference in their cancer treatment journey and long-term quality of life.

 

Addressing Common Concerns

It’s natural to have concerns about any cancer surgery. Let’s address some common questions about SSM:

  1. Is SSM as safe as traditional mastectomy?

Yes, numerous studies have shown that SSM is oncologically safe when performed on appropriate candidates.

  1. Will I need radiation therapy after SSM?

The need for radiation therapy depends on your specific cancer characteristics, not the type of mastectomy performed.

  1. Can I have SSM if I have a large tumor?

SSM may be possible even with larger tumors, depending on their location and other factors. Each case is evaluated individually.

  1. What if cancer is found in the preserved skin?

This is rare, but if it occurs, the affected skin can be removed in a subsequent procedure without compromising overall outcomes.

  1. Will I have feeling in my reconstructed breast?

While sensation is usually reduced after any mastectomy, some feeling may return over time. Newer techniques aim to preserve more sensation.

 

Dr. Hammad Raza Sheikh’s Expertise

As a Consultant Oncoplastic Breast Surgeon, I’ve dedicated my career to providing the best possible outcomes for breast cancer patients. I’ve performed hundreds of SSM procedures, constantly refining my techniques to incorporate the latest advancements.

I regularly attend international conferences and workshops to stay updated on the latest developments in breast cancer surgery. This allows me to bring the best practices from around the world to our patients here in Lahore.

 

Patient Success Stories

While maintaining patient confidentiality, I’d like to share a couple of anonymized case studies that illustrate the effectiveness of SSM:

Case 1: Amina, a 42-year-old mother of three, was diagnosed with early-stage breast cancer. We performed SSM with immediate implant reconstruction. Amina recovered quickly and was thrilled with the natural-looking results. She often mentions how this helped her maintain her sense of femininity during cancer treatment.

Case 2: Fatima, a 38-year-old teacher, underwent bilateral SSM with DIEP flap reconstruction due to a BRCA gene mutation. She recovered well and returned to work within six weeks. Fatima reports feeling confident in her appearance and relieved about her reduced cancer risk.

 

Post-Operative Care in the Pakistani Context

Proper post-operative care is crucial for a successful recovery. Here’s what you can expect:

  1. Pain management: We provide appropriate pain relief medications and techniques.

 

  1. Wound care: We teach you how to care for your surgical sites at home, considering local climate and available resources.
  2. Drain management: We provide clear instructions on how to manage surgical drains.
  3. Follow-up visits: Regular check-ups ensure proper healing and address any concerns promptly.
  4. Physical therapy: We offer guidance on exercises to regain arm mobility and strength.
  5. Emotional support: We understand the psychological impact of breast cancer and surgery. Our team provides support and can refer you to counseling services if needed.
  6. Culturally sensitive care: We respect cultural and religious preferences in all aspects of care.

 

The Future of Skin Sparing Mastectomy in Pakistan

Looking ahead, I’m optimistic about the future of breast cancer care in Pakistan. We’re seeing:

  1. Increased awareness about breast cancer, leading to earlier detection and more treatment options.
  2. More training programs for surgeons in advanced breast surgery techniques.
  3. Growing availability of advanced reconstruction options across the country.
  4. Ongoing research to further improve surgical techniques and outcomes.
  5. Efforts to make advanced breast cancer treatments more accessible to women in rural areas.

As we continue to advance, our goal is to make high-quality breast cancer care accessible to all Pakistani women, regardless of their location or economic status.

The procedure typically takes 2-3 hours, longer if immediate reconstruction is performed.

Most patients can resume light activities within 2-3 weeks, with full recovery in 4-6 weeks.

Most patients stay 1-2 nights in the hospital, depending on the type of reconstruction.

SSM removes all breast tissue, so breastfeeding is not possible afterwards.

Initially, follow-ups are more frequent (every few weeks), then spacing out to annual check-ups after the first year.