Risk-reducing, conservative mastectomy—analysis of surgical outcome and quality of life in 272 implant-based reconstructions using TiLoop ？ Bra versus autologous corial flaps

Breast cancer requires mastectomy in—at least—one out of four women, and the possibility to prevent breast cancer in families with known genetic inheritance by prophylactic surgery increases the demand for this procedure (1,2). If breast conservation (BCT) is not an option, the question arises which type of mastectomy shall be applied. The evolution of surgical techniques for removal of the mammary gland started from Rotter-Halsteds’ radical mastectomy (3) to Patey’s modified mastectomy (4) of the last millenium up to modern concepts with preservation of the skin envelope by skin-sparing mastectomy (SSM), subcutaneous mastectomy (SCM) or nipple-(areola) sparing mastectomy (NSM/NASM) which are considered as oncologically safe (5). Different approaches and incision patterns have been developed for these surgical procedures such as tennis-racket incision pattern, reduction mammaplasty technique as inverted T- or J-incision, up to total or partial periareolar incision. These techniques have been applied mostly according to the surgeons’ preference. The patients’ perspective was not always in the primary focus. BRCA-mutational status has attracted much attention in the last years when individuals of public interest submitted themselves to prophylactic mastectomy in cases of a positive BRCA1/2-mutational status (1). We investigated the patient’s view on these procedures with validated measurements of quality of life (QoL) and explored the surgical safety and acceptance of these surgical procedures