Peng Gao1, Ping Bai2, Yinpeng Ren1, Xiangyi Kong1, Zhongzhao Wang3, Yi Fang4, Jing Wang5. 1. Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China. 2. Department of The Operating Room, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China. 3. Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China. wangzhongzhao206@sina.com. 4. Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China. fangyi@cicams.ac.cn. 5. Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China. wangjing@cicams.ac.cn.
Abstract
BACKGROUND: Biological matrix-assisted one-stage implant-based breast reconstruction (IBBR) could improve the inframammary fold to achieve good esthetic results. However, whether biological matrix-assisted one-stage IBBR yields better postoperative outcomes compared with two-stage IBBR remains unclear. We aimed to compare and analyze surgical complications and patient-reported outcomes (PROs) based on the BREAST-Q version 2.0 questionnaire between biological matrix-assisted one-stage IBBR and traditional two-stage IBBR. METHODS: From May 2015 to June 2019, eligible patients who underwent SIS matrix-assisted one-stage IBBR or two-stage IBBR were enrolled in this retrospective cohort study. PROs were measured with BREAST-Q version 2.0, which scored the health-related quality of life, satisfaction, and experience domains. Complications were divided into major complications (patients requiring reoperation) and minor complications (patients who could be treated in the dressing room). PROs and complications were compared between the SIS matrix-assisted one-stage IBBR and two-stage IBBR groups. A multivariate linear regression analysis was used to identify the social and surgical factors that affected PROs. RESULTS: At our institution, 124 eligible patients were recruited. Seventy-nine patients (63.7%) underwent SIS matrix-assisted one-stage IBBR reconstruction, and 45 patients (36.3%) underwent tissue expander/implant reconstruction (two-stage IBBR). Postoperative BREAST-Q version 2.0 was completed by 68 of 79 patients (86.1%) in the SIS matrix-assisted one-stage IBBR group and by 35 of 45 patients (77.8%) in the two-stage IBBR group. In the satisfaction-related quality of life domain, satisfaction with breast was 9.27 points higher in the SIS matrix-assisted one-stage IBBR group (p = 0.012) compared with the two-stage IBBR group. The multivariate linear regression analysis showed that implant volume (p = 0.031) and postoperative radiotherapy (p = 0.036) significantly influenced the PRO of satisfaction with breast. However, patients in the SIS matrix-assisted one-stage IBBR group had a higher minor complication rate compared with patients in the two-stage IBBR group (p = 0.026). CONCLUSIONS: Our retrospective study showed that although patients treated with biological matrix-assisted one-stage IBBR tended to have higher postoperative complication rates, this technique correlated with better PROs compared with two-stage IBBR. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
BACKGROUND: Biological matrix-assisted one-stage implant-based breast reconstruction (IBBR) could improve the inframammary fold to achieve good esthetic results. However, whether biological matrix-assisted one-stage IBBR yields better postoperative outcomes compared with two-stage IBBR remains unclear. We aimed to compare and analyze surgical complications and patient-reported outcomes (PROs) based on the BREAST-Q version 2.0 questionnaire between biological matrix-assisted one-stage IBBR and traditional two-stage IBBR. METHODS: From May 2015 to June 2019, eligible patients who underwent SIS matrix-assisted one-stage IBBR or two-stage IBBR were enrolled in this retrospective cohort study. PROs were measured with BREAST-Q version 2.0, which scored the health-related quality of life, satisfaction, and experience domains. Complications were divided into major complications (patients requiring reoperation) and minor complications (patients who could be treated in the dressing room). PROs and complications were compared between the SIS matrix-assisted one-stage IBBR and two-stage IBBR groups. A multivariate linear regression analysis was used to identify the social and surgical factors that affected PROs. RESULTS: At our institution, 124 eligible patients were recruited. Seventy-nine patients (63.7%) underwent SIS matrix-assisted one-stage IBBR reconstruction, and 45 patients (36.3%) underwent tissue expander/implant reconstruction (two-stage IBBR). Postoperative BREAST-Q version 2.0 was completed by 68 of 79 patients (86.1%) in the SIS matrix-assisted one-stage IBBR group and by 35 of 45 patients (77.8%) in the two-stage IBBR group. In the satisfaction-related quality of life domain, satisfaction with breast was 9.27 points higher in the SIS matrix-assisted one-stage IBBR group (p = 0.012) compared with the two-stage IBBR group. The multivariate linear regression analysis showed that implant volume (p = 0.031) and postoperative radiotherapy (p = 0.036) significantly influenced the PRO of satisfaction with breast. However, patients in the SIS matrix-assisted one-stage IBBR group had a higher minor complication rate compared with patients in the two-stage IBBR group (p = 0.026). CONCLUSIONS: Our retrospective study showed that although patients treated with biological matrix-assisted one-stage IBBR tended to have higher postoperative complication rates, this technique correlated with better PROs compared with two-stage IBBR. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Keywords:
Biological matrix; Breast cancer; Breast-Q version 2.0; One-stage implant-based breast reconstruction; Tissue expander/implant breast reconstruction
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