Circum-areolar mastectomy with immediate reconstruction (CAMIR)

Aims: To develop an oncologically safe and aesthetically acceptable techniq ue for mastectomy using a myocutaneous flap and tissue expander for patient s with neoplastic involvement of the nipple. Methods: Fourteen consecutive patients (mean age 40 years) underwent a circ um-areolar mastectomy with immediate reconstruction using a latissimus dors i myocutaneous flap and tissue expander. Assessment of cosmesis was by revi ew of pre- and post-operative photographs by an independent observer. Results: During a mean follow-up of 11.4 months there have been no local re currences. There were two deaths: pulmonary embolus tone) and distant metas tatic disease tone). Assessment of cosmesis gave a score of 47 out of 56 (8 4%). Conclusions: In patients with tumours involving the nipple, mastectomy with immediate reconstruction may be used to achieve a good cosmetic result. Th e replacement nipple is fashioned from a circle of skin attached to the lat issimus dorsi myocutaneous harvest. (C) 2000 Harcourt Publishers Ltd.