Single-Stage Immediate Breast Reconstruction with Acellular Dermal Matrix after Breast Cancer: Comparative Study and Evaluation of Breast Reconstruction Outcomes
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patient Population
2.2. Inclusion and Exclusion Criteria
2.3. Surgical Technique
2.4. Study of Complications
2.5. Patient-Reported Outcome Measure
3. Results
3.1. Study Population
3.2. Study Design
3.3. Between-Groups Complication Comparison
3.4. Measuring Patient Outcomes
4. Discussion
4.1. Suitable Mesh
4.2. Complications after Radiotherapy
4.3. Analysis of Results
4.4. Lower Rate of Loss Implant with ADM Use
4.5. Higher Level of Satisfaction with ADM Breast Reconstruction
4.6. Limitations of the Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Mesh (n = 51) | No Mesh (n = 38) | p-Value | Test | |
---|---|---|---|---|
Age | 49.50 (1.49) | 47.93 (1.89) | 0.521 | Student’s t-test |
Diabetes | 2 (3.92%) | 0 (0%) | 0.505 | Fisher’s exact test |
Smoking | 6 (11.76%) | 1 (2.63%) | 0.231 | Fisher’s exact test |
Radiotherapy RT | 16 (31.4%) | 10 (27.0%) | 0.838 | Chi-square with Yates correction |
Pre-operative | 5 (31.3%) | 3 (30.0%) | 1.000 | Fisher’s exact test * |
Post-operative | 11 (68.8%) | 7 (70.0%) | ||
Neoadjuvant Chemotherapy | 29 (56.9%) | 18 (48.6%) | 0.585 | Chi-square with Yates correction |
Adjuvant Chemotherapy | 15 (29.4%) | 7 (18.9%) | 0.383 | Chi-square with Yates correction |
BRCA1 | 7 (13.7%) | 0 (0%) | 0.020 | Fisher’s exact test |
BRCA2 | 2 (3.9%) | 1 (2.7%) | 1 | Fisher’s exact test |
Mesh (n = 62) | No Mesh (n = 41) | p-Value | |
---|---|---|---|
Skin necrosis | 11 (21.6%) | 5 (12.2%) | 0.367 (Chi-square with Yates correction) |
Seroma | 5 (8.1%) | 5 (12.2%) | 0.514 (Fisher’s exact test) |
Extrusion of the implant | 3 (5.9%) | 9 (24.3%) | 0.030 (Fisher’s exact test) |
Total or partial loss of NAC | 3 (4.8%) | 4 (9.8%) | 0.432 (Fisher’s exact test) |
Infection | 3 (4.8%) | 3 (7.3%) | 0.680 (Fisher’s exact test) |
Hematoma | 5 (8.1%) | 3 (7.3%) | 1.000 (Fisher’s exact test) |
Variable | Group | N | Average | SD | Typical Error | Minimum | Maximum | Rank | Median |
---|---|---|---|---|---|---|---|---|---|
Satisfaction with Breasts pre | No Mesh | 29 | 58.66 | 22.283 | 4.138 | 0 | 100 | 100 | 63.00 |
Mesh | 42 | 63.26 | 21.226 | 3.275 | 0 | 100 | 100 | 63.00 | |
Total | 71 | 61.38 | 21.626 | 2.567 | 0 | 100 | 100 | 63.00 | |
PsychoSocial Wellbeing pre | No Mesh | 29 | 67.66 | 16.715 | 3.104 | 37 | 100 | 63 | 67.00 |
Mesh | 42 | 74.60 | 17.576 | 2.712 | 36 | 100 | 64 | 77.50 | |
Total | 71 | 71.76 | 17.450 | 2.071 | 36 | 100 | 64 | 70.00 | |
Physical Wellbeing Chest pre | No Mesh | 29 | 61.86 | 16.803 | 3.120 | 31 | 100 | 69 | 60.00 |
Mesh | 41 | 64.34 | 15.244 | 2.381 | 25 | 100 | 75 | 63.00 | |
Total | 70 | 63.31 | 15.837 | 1.893 | 25 | 100 | 75 | 62.00 | |
Physical Wellbeing Abdomen pre | No Mesh | 28 | 68.07 | 21.022 | 3.973 | 25 | 100 | 75 | 72.00 |
Mesh | 40 | 75.70 | 22.869 | 3.616 | 14 | 100 | 86 | 83.00 | |
Total | 68 | 72.56 | 22.289 | 2.703 | 14 | 100 | 86 | 77.50 | |
Sexual Wellbeing pre | No Mesh | 26 | 48.58 | 20.379 | 3.997 | 16 | 100 | 84 | 46.00 |
Mesh | 41 | 62.73 | 22.808 | 3.562 | 16 | 100 | 84 | 60.00 | |
Total | 67 | 57.24 | 22.823 | 2.788 | 16 | 100 | 84 | 54.00 | |
Satisfaction with Breasts post | No Mesh | 26 | 54.46 | 17.591 | 3.450 | 20 | 78 | 58 | 56.00 |
Mesh | 41 | 66.22 | 16.044 | 2.506 | 40 | 100 | 60 | 65.00 | |
Total | 67 | 61.66 | 17.509 | 2.139 | 20 | 100 | 80 | 62.00 | |
Satisfaction with Outcome post | No Mesh | 25 | 77.96 | 21.532 | 4.306 | 35 | 100 | 65 | 75.00 |
Mesh | 40 | 82.90 | 17.666 | 2.793 | 35 | 100 | 65 | 80.50 | |
Total | 65 | 81.00 | 19.233 | 2.386 | 35 | 100 | 65 | 75.00 | |
PsychoSocial Wellbeing post | No Mesh | 26 | 71.54 | 18.862 | 3.699 | 41 | 100 | 59 | 70.00 |
Mesh | 39 | 79.26 | 18.113 | 2.900 | 26 | 100 | 74 | 49.00 | |
Total | 65 | 76.17 | 18.663 | 2.315 | 26 | 100 | 74 | 76.00 | |
Sexual Wellbeing post | No Mesh | 23 | 49.91 | 21.753 | 4.536 | 16 | 100 | 84 | 49.00 |
Mesh | 38 | 64.50 | 24.380 | 3.955 | 0 | 100 | 100 | 60.00 | |
Total | 61 | 59.00 | 24.307 | 3.112 | 0 | 100 | 100 | 57.00 | |
Physical Wellbeing Chest post | No Mesh | 26 | 56.92 | 15.226 | 2.986 | 47 | 100 | 53 | 50.00 |
Mesh | 35 | 51.29 | 3.777 | 0.639 | 50 | 68 | 18 | 50.00 | |
Total | 61 | 53.69 | 10.611 | 1.359 | 47 | 100 | 53 | 50.00 | |
Physical Wellbeing Abdomen post | No Mesh | Not evaluated because they do not apply to operated patients | |||||||
Mesh | |||||||||
Total | |||||||||
Satisfaction with Nipples post | No Mesh | Not evaluated because they do not apply to operated patients | |||||||
Mesh | |||||||||
Total | |||||||||
Satisfaction with Information post | No Mesh | 23 | 65.13 | 19.485 | 4.063 | 25 | 100 | 75 | 60.00 |
Mesh | 38 | 75.03 | 20.346 | 3.301 | 22 | 100 | 78 | 72.50 | |
Total | 61 | 71.30 | 20.442 | 2.617 | 22 | 100 | 78 | 69.00 | |
Surgeon post | No Mesh | 25 | 88.28 | 19.208 | 3.842 | 31 | 100 | 69 | 100.00 |
Mesh | 38 | 92.34 | 13.869 | 2.250 | 29 | 100 | 71 | 100.00 | |
Total | 63 | 90.73 | 16.175 | 2.038 | 29 | 100 | 71 | 100.00 | |
Medical Staff post | No Mesh | 25 | 99.36 | 3.200 | 0.640 | 84 | 100 | 16 | 100.00 |
Mesh | 40 | 96.20 | 8.489 | 1.342 | 74 | 100 | 26 | 100.00 | |
Total | 65 | 97.42 | 7.082 | 0.878 | 74 | 100 | 26 | 100.00 | |
Office Staff post | No Mesh | 24 | 99.00 | 3.502 | 0.715 | 85 | 100 | 15 | 100.00 |
Mesh | 37 | 95.08 | 12.698 | 2.088 | 43 | 100 | 57 | 100.00 | |
Total | 61 | 96.62 | 10.255 | 1.313 | 43 | 100 | 57 | 100.00 |
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Dueñas-Rodríguez, B.; Navarro-Cecilia, J.; Luque-López, C.; Sánchez-Andujar, B.; Garcelán-Trigo, J.A.; Ramírez-Expósito, M.J.; Martínez-Martos, J.M. Single-Stage Immediate Breast Reconstruction with Acellular Dermal Matrix after Breast Cancer: Comparative Study and Evaluation of Breast Reconstruction Outcomes. Cancers 2023, 15, 5349. https://doi.org/10.3390/cancers15225349
Dueñas-Rodríguez B, Navarro-Cecilia J, Luque-López C, Sánchez-Andujar B, Garcelán-Trigo JA, Ramírez-Expósito MJ, Martínez-Martos JM. Single-Stage Immediate Breast Reconstruction with Acellular Dermal Matrix after Breast Cancer: Comparative Study and Evaluation of Breast Reconstruction Outcomes. Cancers. 2023; 15(22):5349. https://doi.org/10.3390/cancers15225349
Chicago/Turabian StyleDueñas-Rodríguez, Basilio, Joaquín Navarro-Cecilia, Carolina Luque-López, Belén Sánchez-Andujar, Juan Arsenio Garcelán-Trigo, María Jesús Ramírez-Expósito, and José Manuel Martínez-Martos. 2023. "Single-Stage Immediate Breast Reconstruction with Acellular Dermal Matrix after Breast Cancer: Comparative Study and Evaluation of Breast Reconstruction Outcomes" Cancers 15, no. 22: 5349. https://doi.org/10.3390/cancers15225349
APA StyleDueñas-Rodríguez, B., Navarro-Cecilia, J., Luque-López, C., Sánchez-Andujar, B., Garcelán-Trigo, J. A., Ramírez-Expósito, M. J., & Martínez-Martos, J. M. (2023). Single-Stage Immediate Breast Reconstruction with Acellular Dermal Matrix after Breast Cancer: Comparative Study and Evaluation of Breast Reconstruction Outcomes. Cancers, 15(22), 5349. https://doi.org/10.3390/cancers15225349