28. The safety of polypropylene mesh in nipple-sparing mastectomy and immediate implant-based breast reconstruction in early breast cancer patients

Bui Duc Tung, Pham Xuan Dung, Le Van Quang

Nội dung chính của bài viết

Tóm tắt

The study aimed to determine the incidence and severity of postoperative complications in early breast cancer (BC) females undergoing immediate breast reconstruction (IBR) with implant and polypropylene mesh (PPM) after nipple-sparing mastectomy (NSM). This study is a retrospective, single-arm and single-institutional trial. The population selected was females with BC treated at Ho Chi Minh City Oncology Hospital from July 01, 2022, to Jan 31, 2024. The inclusion criteria included pathology as carcinoma of breast at preoperative stage as 0, I or II with tumor less than 3cm, and being treated with NSM followed by implant-based IBR with PPM. 28 patients met the inclusion criteria. Of two patients, the former had a late infection, whereas the latter suffered from nipple-areolar necrosis, accounting for 8% of all. Both patients were well managed with medical therapy. We did not find any statistical significance between the postoperative complications and relevant clinical and therapeutic characteristics. PPM enables the cavity to hold the implant, while still maintaining natural breast appearance. This is a safe surgical procedure to perform. PPM may be considered as an alternative for covering the lower anterior aspect of implant, especially in developing countries like Vietnam.

Chi tiết bài viết

Tài liệu tham khảo

1. Sung H, Ferlay J, Siegel RL, and et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. May 2021; 71(3): 209-249.
2. Ferlay JEM, Lam F, Laversanne M, and et al. Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer. 2024. https://gco.iarc.who.int/media/globocan/factsheets/populations/704-viet-nam-fact-sheet.pdf.
3. Lee YJ, Yoo TK, Kim J, and et al. Survival outcomes of breast cancer patients with recurrence after surgery according to period and subtype. PLoS One. 2023; 18(7): e0284460.
4. Faulkner HR, Shikowitz-Behr L, McLeod M, and et al. The Use of Absorbable Mesh in Implant-Based Breast Reconstruction: A 7-Year Review. Plast Reconstr Surg. Dec 2020; 146(6): 731e-736e.
5. Ahmed S, Snelling A, Bains M, Whitworth IH. Breast reconstruction. BMJ. Apr 23 2005; 330(7497): 943-8.
6. Hartzell TL, Taghinia AH, Chang J, Lin SJ, Slavin SA. The use of human acellular dermal matrix for the correction of secondary deformities after breast augmentation: results and costs. Plast Reconstr Surg. Nov 2010; 126(5): 1711-1720.
7. Tessler O., Reish R.G., Maman D.Y., Smith B.L., Austen W.G., Jr. Beyond biologics: absorbable mesh as a low-cost, low-complication sling for implant-based breast reconstruction. Plast Reconstr Surg. Feb 2014; 133(2): 90e-99e.
8. Forsberg CG, Kelly DA, Wood BC, and et al. Aesthetic outcomes of acellular dermal matrix in tissue expander/implant-based breast reconstruction. Ann Plast Surg. 2014; 72(6): S116-20.
9. Scheflan M, Colwell AS. Tissue Reinforcement in Implant-based Breast Reconstruction. Plast Reconstr Surg Glob Open. Aug 2014; 2(8): e192.
10. Hansson E, Edvinsson AC, Elander A, Kolby L, Hallberg H. First-year complications after immediate breast reconstruction with a biological and a synthetic mesh in the same patient: A randomized controlled study. J Surg Oncol. Jan 2021; 123(1): 80-88.
11. Blok YL, van Lierop E, Plat VD, Corion LUM, Verduijn PS, Krekel NMA. Implant Loss and Associated Risk Factors following Implant-based Breast Reconstructions. Plast Reconstr Surg Glob Open. Jul 2021; 9(7): e3708.
12. Gschwantler-Kaulich D, Schrenk P, Bjelic-Radisic V, Unterrieder K, and et al. Mesh versus acellular dermal matrix in immediate implant-based breast reconstruction - A prospective randomized trial. Eur J Surg Oncol. May 2016; 42(5): 665-71.
13. Phạm Huỳnh Anh Tuấn, Trần Việt Thế Phương. Tái tạo vú tức thì bằng túi độn trong điều trị carcinôm vú giai đoạn sớm. Luận văn tốt nghiệp Chuyên khoa cấp 2. Đại học Y Dược Thành Phố Hồ Chí Minh; 2021.
14. Trần Văn Thiệp, Trương Văn Trường, Huỳnh Hồng Hạnh, và cs. Đoạn nhũ tiết kiệm da - tái tạo vú tức thì: kết quả thẩm mỹ và ung bướu học. Y hoc Thành phố Hồ Chí Minh. 2008; 12(04): 377-382.
15. Santosa KB, Qi J, Kim HM, Hamill JB, and et al. Long-term Patient-Reported Outcomes in Postmastectomy Breast Reconstruction. JAMA Surg. Oct 1 2018; 153(10): 891-899.
16. Samaha Y, Chen J, Ray EC. ADMs and synthetic meshes improve implant-based breast reconstruction aesthetics, but at what cost? J Plast Reconstr Aesthet Surg. May 2023; 80: 178-181.
17. Choi YS, You HJ, Lee TY, Kim DW. Comparing Complications of Biologic and Synthetic Mesh in Breast Reconstruction: A Systematic Review and Network Meta-Analysis. Arch Plast Surg. Jan 2023; 50(1): 3-9.