Fabinshy Thangarajah1,2, Timo Treeter1, Barbara Krug3, Martin Hellmich4, Christian Eichler1,2, Bettina Hanstein1,2, Peter Mallmann1, Wolfram Malter1,2. 1. Department of Obstetrics and Gynecology, Faculty of Medicine and University Hospital, University of Cologne, Cologne. 2. Breast Center, University Hospital Cologne, Cologne. 3. Department of Diagnostical and Interventional Radiology, University of Cologne Medical School, Cologne. 4. Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany.
Abstract
INTRODUCTION: Implant-based immediate breast reconstruction (IBR) is a common surgical procedure in breast cancer patients. Comparative analysis concerning the placement of implants is still lacking. Hence, we aimed to analyze pre- versus subpectoral IBR in breast cancer patients. PATIENTS: A single-center experience with implant-based IBR following skin/nipple-sparing mastectomy was evaluated. Patient demographics, incidence of major complications, and quality of life assessed with BREAST-Q were compared between the pre- and subpectoral cohort. RESULTS: A total of 63 patients were included in this analysis of whom 29 underwent subpectoral and 34 underwent prepectoral IBR. Median duration of surgery was prolonged in the subpectoral versus the prepectoral group (104 ± 28 vs. 80 ± 91 min; p < 0.05). The mean number of major complications was significantly increased in the subpectoral group (1.41 ± 1.76 vs. 0.47 ± 0.75 per patient; p < 0.05). Detailed analysis showed a significantly increased incidence of implant dislocation (p < 0.05) and a trend concerning capsular contracture (p = 0.086, not significant) and necrosis (p = 0.092, not significant) in the subpectoral group. Quality of life was equal in both groups. CONCLUSION: The mean number of major complications in the subpectoral group should be considered when IBR is indicated. Prepectoral IBR seems to be a feasible alternative surgical treatment option with less major complications in selected patients.
INTRODUCTION: Implant-based immediate breast reconstruction (IBR) is a common surgical procedure in breast cancer patients. Comparative analysis concerning the placement of implants is still lacking. Hence, we aimed to analyze pre- versus subpectoral IBR in breast cancer patients. PATIENTS: A single-center experience with implant-based IBR following skin/nipple-sparing mastectomy was evaluated. Patient demographics, incidence of major complications, and quality of life assessed with BREAST-Q were compared between the pre- and subpectoral cohort. RESULTS: A total of 63 patients were included in this analysis of whom 29 underwent subpectoral and 34 underwent prepectoral IBR. Median duration of surgery was prolonged in the subpectoral versus the prepectoral group (104 ± 28 vs. 80 ± 91 min; p < 0.05). The mean number of major complications was significantly increased in the subpectoral group (1.41 ± 1.76 vs. 0.47 ± 0.75 per patient; p < 0.05). Detailed analysis showed a significantly increased incidence of implant dislocation (p < 0.05) and a trend concerning capsular contracture (p = 0.086, not significant) and necrosis (p = 0.092, not significant) in the subpectoral group. Quality of life was equal in both groups. CONCLUSION: The mean number of major complications in the subpectoral group should be considered when IBR is indicated. Prepectoral IBR seems to be a feasible alternative surgical treatment option with less major complications in selected patients.
Authors: Maurizio B Nava; Joseph Ottolenghi; Angela Pennati; Andrea Spano; Novella Bruno; Giuseppe Catanuto; Dominik Boliglowa; Valentina Visintini; Stefano Santoro; Secondo Folli Journal: Breast Date: 2011-03-23 Impact factor: 4.380
Authors: Leonardo Cattelani; Susanna Polotto; Maria Francesca Arcuri; Giuseppe Pedrazzi; Chiara Linguadoca; Elena Bonati Journal: Clin Breast Cancer Date: 2017-12-02 Impact factor: 3.225
Authors: Steven Sigalove; G Patrick Maxwell; Noemi M Sigalove; Toni L Storm-Dickerson; Nicole Pope; Jami Rice; Allen Gabriel Journal: Plast Reconstr Surg Date: 2017-02 Impact factor: 4.730