Main Article Content
breast reconstruction; immediate breast reconstruction; breast cancer; ADM; breast implant;
The aim of this retrospective study is to evaluate the patient-reported outcome after immediate ADM-assisted implant- based breast reconstruction.
Material and Methods
Patients underwent breast reconstruction from 2015 to 2019 have been retrospectively divided into group A (partial subpectoral implant and ADM and group B (expander/implant). For each patient we evaluated retrospectively postoperative complications and patients’ satisfaction.
26 patients from the case group and 40 from the control group completed the BREAST-Q. The incidence of complications in the cases was 18.4%, while in the control group was 20.4%. We found no statistical difference in most of the domains and in the mean score of the questionnaire (mean score cases=69.0±14.4 vs controls=68.4±15.7; p=0.888). A significant difference results only in the domains Q2a and Q2b, sensation of rippling.
Conclusions. The use of ADM in one-stage reconstruction allows to perform breast reconstruction in only one surgery, with similar complication rates and patient satisfaction.
2.Veronesi U, Saccozzi R, Del Vecchio M, et al., Comparing radical mastectomy with quadrantectomy, axillary dissection, and radiotherapy in patients with small cancers of the breast. N Engl J Med 1981; 305: 6-11.
3.Bernard Fisher, M.D., Stewart Anderson, Ph.D., John Bryant, et al., Twenty-Year Follow-up of a Randomized Trial Comparing Total Mastectomy, Lumpectomy, and Lumpectomy plus Irradiation for the Treatment of Invasive Breast Cancer. N Engl J Med 2002; 347:1233-1241
4.Sabel MS, Kraft CT, Griffith KA, et al. Differences between breast conservation-eligible patients and unilateral mastectomy patients in choosing contralateral prophylactic mastectomies. Breast J. 2016; 22:607–615.
5. Salzberg CA.Nonexpansive immediate breast reconstruction using human acellular tissue matrix graft (AlloDerm). Ann Plast Surg. 2006 Jul;57(1):1-5.
6. Nicolò Bertozzi, Marianna Pesce, Pierluigi Santi, and Edoardo Raposio. One-Stage Immediate Breast Reconstruction: A Concise Review. Biomed Res Int. 2017;2017:64868597.
7. Eicheler C, Efremova J, Brunnert K, et al. A Head to Head Comparison Between Surgimend®-Fetal Bovine Acellular Dermal Matrix and Tutomesh®- A Bovine Pericardium Collagene Membrane in Breast Reconstruction in 45 Cases. In vivo 31: 677-682 (2017).
8. Cano SJ, Klassen AF, Scott AM et al., The BREAST-Q: further validation in indipendent clinical samples. Plast Reconstr Surg. 2012 Feb;129(2):293-302
9. Parisi D, Ciancio F, Portincasa A, Innocenti A. Direct-to-Implant Breast Reconstruction without the Use of an Acellular Dermal Matrix Is Cost Effective and Oncologically Safe. Plast Reconstr Surg. 2017 Dec;140(6):820e-821e
10. Duncan DI. Correction of implant rippling using allograft dermis. Aesth Surg J 2001;21:81-4.
11. Breuing KH, Warren SM. Immediate bilateral breast reconstruction with implants and inferolateral AlloDerm slings. Ann Plast Surg 2005; 55:232-9.
12. Annacontini L, Ciancio F, Parisi D, Innocenti A, Portincasa A. Management of nipple-areolar complex complications in skin-sparing mastectomy with prosthetic reconstruction A case report. Ann Ital Chir. 2016 Jan 29;87(ePub). pii: S2239253X16024440.
13. Razdan SN, Cordeiro PG, Albornoz CR, et al. Cost-effectiveness analysis of breast reconstruction options in the setting of postmastectomy radiotherapy using the BREAST-Q. Plast Reconstr Surg. 2016 Mar;137(3):510e-517e
14. Wei CH, Scott AS, Price AN, et al. Psychosocial and sexual well-being following nipple-sparing mastectomy and reconstruction. Breast J. 2016; 22:10–17.
15. Susini T., Renda I., Giani M., Vallario A., Nori J., Vanzi E., Innocenti A., Lo Russo G., Bianchi S. Changing Trends in Mastectomy and Breast Reconstruction. Analysis of a Single-institution Experience Between 2004-2016. Anticancer Res. 2019 Oct;39(10):5709-5714. doi: 10.21873/anticanres.13770.
16. SA Macadam, PA Lennox. Acellular dermal matrices: Use in reconstructive and aesthetic breast surgery. Can J Plast Surg 2012;20(2):75-90.
17. G. Ho, T. J. Nguyen, A. Shahabi, et al., “A systematic review and meta-analysis of complications associated with acellular dermal matrix-assisted breast reconstruction,” Annals of Plastic Surgery, vol. 68, no. 4, pp. 346–356, 2012.
18. Basta MN, Gerety PA, Serletti JM, et al. A Systematic Review and Head-to-Head Meta Analysis of Outcomes following Direct-to-Implant versus Conventional Two-Stage Implant Reconstruction. Plastic and Reconstructive Surgery. 2015 Dec;136(6):1135-44
19. Ciancio F, Parisi D, Portincasa A, Innocenti A. Innovative Management of Implant Exposure in ADM/Implant-Based Breast Reconstruction with Negative Pressure Wound Therapy. Aesthetic Plast Surg. 2017 Oct;41(5):1237-1238
20. El Hage Chehade H, Headon H, Wazir U, et al. Nipple-sparing mastectomy using a hemi-periareolar incision with or without minimal medial-lateral extensions; clinical outcome and patient satisfaction: A single centre prospective observational study. Am J Surg. 2017 Jun;213(6): 1116-1124.
21. Headon H, Kasem A, Manson A, et al. Clinical outcome and patient satisfaction with the use of bovine-derived acellular dermal matrix (SurgiMend™) in implant based immediate reconstruction following skin sparing mastectomy: a prospective observational study in a single centre. Surg Oncol 2016; 25: 104-110.
22. Srinivasa DR, Garvey PB, Qi J, Hamill JB, Kim HM, Pusic AL, Kronowitz SJ, Wilkins EG, Butler CE, Clemens MW. Direct-to-Implant versus Two-Stage Tissue Expander/Implant Reconstruction: 2-Year Risks and Patient-Reported Outcomes from a Prospective, Multicenter Study. Plast Reconstr Surg. 2017 November ; 140(5): 869–877.
23. Negenborn V, Young-Afat D, Dikmans R, et al., Quality of life and patient satisfaction after one-stage implant -based breast reconstruction with an acellular dermal matrix versus two-stage breast breconstruction (BRIOS): primary outcome of a randomised, controlled trial. Lancet Oncol. 2018 Sep;19(9):1205-1214.