Now, breast reconstruction is being performed in many cases after mastectomy by using tissue expander or TRAM flap. But conventional mastectomy leaves a long linear scar tissue which is also seen on the breast skin after breast reconstruction. Skin sparing mastectomy with immediate reconstruction leaves a minimal scar tissue, even though, with circumareolar incision, it makes no visible scar tissue.

The purpose of this study is l) to identify the clinical indications for skin-sparing mastectomy (SSM) with immediate reconstruction, 2) to evaluate the clinical results and 3) to encourage the application of this method.

During recent 20 months, breast cancer surgery were 467 cases, mastectomy were 368 (78.8%, 368/467), mastectomy with breast reconstruction were 30 cases (8.2%, 30/368). Among 30 reconstruction cases, skin-sparing mastectomy (SSM) with circumareolar incision and immediate reconstruction were performed in 9 patient. Our patient selection criteria was as follows; 1) patient's desire of reconstruction on cosmetic aspect 2) clinically early breast cancer 3) moderate breast size 4) central locating tumor 5) no skin involvement.

1) we performed 9 cases of skin-sparing mastectomy (SSM) with circumareolar incision and immediate reconstruction. 2)Three patient who complainted palpable mass were diagnosed by FNA for breast cancer and the other 6 patient were proved by ductal biopsy in 4 cases whose complaint was bloody nipple discharge, a H-wire biopsy in whose mammography revealed multiple microcalcifications and a punch biopsy in whose nipple was eczematous. All cases were suspected for early breast cancer preoperatively. 3) Four cases were stage 0, 3 cases were stage I lesions and 2 cases were stage III in postoperative pathologic staging. 4) All the patients were satisfied with their cosmetic results.

Skin-sparing mastectomy (SSM) with immediate reconstruction is new method for breast cancer operation with modified skin incision and shows good aesthetic results. We propose more frequent application of this method for indicated patient, but we need futher follow-up of local recurrence rate and detection rate in these patients.