Early results of subcutaneous mastectomy with immediate silicone prosthetic implant for carcinoma of the breast.

Surgery for carcinoma of the breast is becoming less radical even to the extent of breast conservation. Subcutaneous mastectomy and implant offers itself as an alternative, retaining a breast shape and removing almost all breast tissue. Forty-four consecutive patients who had this procedure for breast carcinoma were studied with a follow-up of 5-44 months (mean 25.3 months). Only 4 patients (9 per cent) had local recurrences, i.e. recurrence in the skin flap or scar. This compares favourably with other series and other forms of treatment. Removal of the prosthesis was necessary in 10 patients due to local factors. The cosmetic result as assessed by the patients was almost universally pleasing. Twenty-six of 27 patients with prostheses in situ who were interviewed in person or by postal questionnaire were pleased with the results of their surgery. The absence of high recurrence rates locally and high patient acceptance makes this a definite surgical alternative.