Single stage immediate breast reconstruction with acellular dermal matrix and implant: Defining the risks and outcomes of post-mastectomy radiotherapy

Apte, Anuradha; Walsh, Maia; Balaji, Prashanth; Khor, Boyuan; Chandrasekharan, Sankaran; Chakravorty, Arunmoy

doi:10.1016/j.surge.2019.09.007

Cited by 13 publications

(8 citation statements)

References 28 publications

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“…They found no significant risk of implant loss 1.1% vs 3.6%, rippling of 0.6% vs 0, seroma 8% vs 7.1%, and infection 5.2% vs 0 between the two groups. However, the capsular contracture rate was higher in the PMRT group, 10.7% compared to non-PMRT group 0.6%, which was statistically significant 37,38 . In comparison, the effect of PMRT in patients who had subpectoral implant-based breast reconstruction versus prepectoral one, contracture rate was significantly higher for the subpectoral patients with PMRT than for the prepectoral patients with PMRT (52.2 vs 16.1%; P=0.0018) 24 .…”

Section: Breast Reconstruction and Radiotherapymentioning

confidence: 74%

“…The study looked at IBR with ADM with and without radiotherapy in n=91 patients; this showed no significant difference in the revision surgeries in the 2 group. Still, the rate of capsular contracture was higher in the RT group 37 . 2020…”

Section: Chandersekarans Apte Amentioning

confidence: 76%

“…In patients with Prepectoral breast reconstruction with ADM's or synthetic mesh with postmastectomy radiotherapy, we found studies to be in favour of use of radiotherapy 31,37,38 . Prepectoral breast reconstruction group had minimal or comparable complication rates (25% in irradiated vs 23% in the non-irradiated group) compared with the subpectoral group (Table 2).…”

Section: Leonardo Cattelani Susanna Polottomentioning

confidence: 89%

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The Journey of Prepectoral Breast Reconstruction through Time

Chopra

Al-Ishaq

Vidya

2021

WJPS

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BACKGROUNDThe facet of breast reconstruction has evolved from complex surgery to simple implant-based breast reconstruction. Minimal invasive surgery or Prepectoral breast reconstruction has revolutionised the surgical treatment for breast cancer and became a reality due to advances in meshes and implants. In this review, we have looked at the journey of Prepectoral implant beast reconstruction through time. METHODSWe conducted a literature review on pre-pectoral breast reconstruction, emphasising types of cover, its outcomes, complications, and the effect of postmastectomy radiotherapy. RESULTSPrepectoral breast reconstruction had advanced with time and appears to be a safe and effective method of breast reconstruction and is associated with minimal morbidity whilst providing adequate cosmesis. Radiotherapy seems to be well tolerated with early favourable results. The Implant loss rates in the Acellular Dermal Matrix (ADM) to be around 5%-6% and rippling appear to be a common adverse effect of this technique ranging from 0%-35% in various studies. CONCLUSIONPrepectoral implant-based breast reconstruction has emerged as a successful method of breast reconstruction.

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Section: Breast Reconstruction and Radiotherapymentioning

confidence: 74%

Section: Chandersekarans Apte Amentioning

confidence: 76%

Section: Leonardo Cattelani Susanna Polottomentioning

confidence: 89%

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The Journey of Prepectoral Breast Reconstruction through Time

Chopra

Al-Ishaq

Vidya

2021

WJPS

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“…The pre-pectoral breast reconstruction is burdened by the following patient complaints: rippling (up to 4.5%) and visible implants (4.3%). The submuscular breast reconstruction is burdened by postoperative pain with significant impact on daily activities (5%), implant deformity and less-natural cosmetic outcomes (until 7%) [ 6 , 93 , 108 , 117 , 118 , 119 , 120 , 121 , 122 , 123 , 124 ]. Onesti et al suggested a modified technique in obesity patients with large breasts, using a dermal flap to cover the ADM-implant in the pre-pectoral plane, in order to improve the outcomes.…”

Section: Resultsmentioning

confidence: 99%

Submuscular and Pre-pectoral ADM Assisted Immediate Breast Reconstruction: A Literature Review

Cuomo

2020

Medicina

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Background and objectives: Breast cancer treatment has deeply changed in the last fifty years. Acellular dermal matrices (ADMs) were introduced for breast reconstruction, with encouraging results, but with conflicting reports too. The present paper aims to summarize the current data on breast reconstruction using acellular dermal matrices. Materials and Methods: We reviewed the literature regarding the use of ADM-assisted implant-based breast reconstruction. Results: The main techniques were analyzed and described. Conclusions: Several authors have recently reported positive results. Nevertheless, an increased complications’ rate has been reported by other authors. Higher cost compared to not-ADM-assisted breast reconstruction is another concern.

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“…The following data were extracted from each article: author, publication year, type of cohort, age, number of breasts in each group (PMRT/non-PMRT), RT protocol and timing, and length of follow-up. The surgical outcomes were classified, as Apte et al 9 proposed, in early or late complications according to the timing of each event, less than 6 weeks postsurgery, or more than 6 weeks postoperative. Early complications included surgical site infection, mastectomy flap necrosis, seroma/hematoma, and implant extrusion.…”

Section: Methodsmentioning

confidence: 99%

The Impact of Adjuvant Radiotherapy on Immediate Implant-based Breast Reconstruction Surgical and Satisfaction Outcomes: A Systematic Review and Meta-analysis

Zugasti

Hontanilla

2021

Plastic and Reconstructive Surgery - Global Open

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Background: Adjuvant radiotherapy could be a necessary step in the oncological treatment for breast cancer. However, radiotherapy may have negative effects on implant-based immediate breast reconstruction. The aim of this study was to determine the impact of adjuvant radiation therapy on surgical results and patientreported satisfaction outcomes in women undergoing immediate implant-based breast reconstruction. Methods: A systematic search in PubMed was conducted on September 2019 and updated on April 2021. The risk of bias of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Form for Observational Studies. RevMan 5 was used for statistical analysis. We obtained relative risks to determine the complication incidence and mean differences for 2-year BREAST-Q scores. Results: Fourteen studies were included. A total of 11,958 implant-based immediate reconstructions were performed, 2311 received postmastectomy radiation therapy, and 9647 were considered as control group. Surgical complications, reoperation rates, and reconstruction failure were significantly higher among irradiated breasts. Significantly lower BREAST-Q scores were reported by irradiated women receiving radiotherapy. Conclusions: This systematic review and meta-analysis combines reconstruction complication rates with aesthetic and patient-reported satisfaction outcomes. Adjuvant radiotherapy is consistently associated with greater complication rates and poorer aesthetic and satisfaction outcomes. The magnitude of association is significantly lower when the reconstruction is based on autologous tissues.

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Single stage immediate breast reconstruction with acellular dermal matrix and implant: Defining the risks and outcomes of post-mastectomy radiotherapy

Cited by 13 publications

References 28 publications

The Journey of Prepectoral Breast Reconstruction through Time

The Journey of Prepectoral Breast Reconstruction through Time

Submuscular and Pre-pectoral ADM Assisted Immediate Breast Reconstruction: A Literature Review

The Impact of Adjuvant Radiotherapy on Immediate Implant-based Breast Reconstruction Surgical and Satisfaction Outcomes: A Systematic Review and Meta-analysis

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