ArticleJPRAS open2026
Outcomes and recurrence trends after skin-sparing mastectomy and immediate DIEP flap reconstruction: A single-centre analysis.
Article in JPRAS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionMastectomy is indicated in 25-40% patients diagnosed with breast cancer. Skin and Nipple sparing mastectomy (SSM / NSM) are techniques that allow for the option of a single stage reconstructive procedure. DIEP flap remains the gold standard for autologous breast reconstruction with excellent aesthetic outcomes. The aim of this study was to evaluate long term results and recurrence patterns following skin sparing mastectomy and immediate reconstruction (IBR) with DIEP flap.
methodsData were collated retrospectively for all consecutive adult patients undergoing immediate DIEP reconstruction following SSM between 1st July 2010 to 30th June 2023 for all indications at the author's centre. Those who underwent delayed DIEP reconstruction or other methods of IBR were excluded. Primary outcome was the incidence and management of locoregional and distant recurrence(LR) and secondary outcomes included other standard oncological measures and immediate post-operative measures such as skin flap changes following SSM.
resultsA total of 235 DIEP flaps in 192 patients at a mean(SD) age of 49(40-57) years were analysed. Median(SD) follow up duration was 7.2(1.4-13) years. The isolated local recurrence rate was 2.7%. LR in conjunction with distant metastasis was seen in a further 2.7% and isolated distant metastases were noted in 8.4% patients. LR occurred at a median of 2.76 (0.97-4.55) years from surgery. Isolated LR were treated with surgical resection & flap conservation followed by adjuvant chemoradiation, whereas distant metastases were treated with palliative chemoradiation as appropriate.
conclusionIBR with DIEP following SSM remains oncologically safe with low recurrence rates. LR can be safely managed with excision and conservation of the DIEP flap.
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