Search Results (3)

Background/Objectives: To quantitatively assess the long-term volume stability of acellular dermal matrix (ADM) in oncoplastic breast-conserving surgery (OBCS) and analyze surgical and aesthetic outcomes. Methods: This retrospective study examined 172 breast cancer patients who underwent OBCS with immediate ADM-based volume replacement (2020–2022). Patients received either diced ADM with sheet ADM (n = 102) or diced ADM with paste ADM (n = 70). The ADM volume was evaluated using MRI at 6, 12, and 24 months postoperatively. Results: Long-term volume stability was achieved in both groups with minimal volume reduction (4.3–4.5%) at 24 months (p < 0.001). Early surgical complications included hematoma (4.1%), seroma (2.3%), and wound issues (1.2%), with no infections or ADM non-incorporation. Contour irregularities occurred in 16.3% of cases. Radiotherapy (87% of patients) did not significantly impact ADM volume retention. Conclusions: ADM provides predictable, durable volume replacement in OBCS, with excellent volume stability even with radiotherapy. This quantitative assessment of ADM volume retention over two years supports ADM as a reliable option for breast-conserving surgery, potentially expanding treatment options for patients with unfavorable tumor-to-breast volume ratios. Full article

Background/Objectives: Oncoplastic breast-conserving surgery (OBCS) with acellular dermal matrix (ADM) has gained prominence in contemporary breast cancer management, yet evidence-based guidelines for selecting optimal ADM techniques based on the tumor location remain undefined. This investigation evaluated the impact of the tumor quadrant location and ADM application methodology on aesthetic outcomes, patient satisfaction, and postoperative complications following OBCS. Methods: This retrospective comparative analysis examined 229 patients who underwent OBCS with immediate ADM-based volume replacement (2020–2022) utilizing three distinct techniques: the diced ADM with sheet technique (n = 102), the diced ADM with paste-type micronized technique (n = 70), or the diced ADM-only technique (n = 57). The outcomes were stratified by tumor location (superomedial, superolateral, inferomedial, and inferolateral) and evaluated using validated physician-assessed aesthetic scores (four-point scale), patient satisfaction metrics, and comprehensive complication profiling with 24-month minimum follow-up. Results: The tumor quadrant location significantly influenced aesthetic outcomes across all techniques (p < 0.001), with superolateral quadrants demonstrating superior results (3.5 ± 0.4). In the superomedial quadrant, the diced ADM with paste-type micronized technique yielded significantly higher aesthetic scores than the diced ADM-only technique (3.2 ± 0.5 vs. 2.8 ± 0.6, p = 0.032, Cohen’s d = 0.71). In the superolateral quadrant, the diced ADM-only technique achieved superior outcomes compared with the diced ADM with sheet technique (3.6 ± 0.4 vs. 3.4 ± 0.5, p = 0.020, d = 0.44). For inferomedial defects, the diced ADM with sheet technique demonstrated significant advantages over the diced ADM-only technique (2.9 ± 0.7 vs. 2.7 ± 0.7, p = 0.005, d = 0.29). A consistent discrepancy between physician and patient assessments was observed, particularly in medial quadrant reconstructions (mean difference: 0.2 points, p = 0.003). Conclusions: The optimal ADM technique varied significantly by tumor location. The diced ADM with paste-type micronized technique demonstrated superior outcomes in superomedial defects, the diced ADM with sheet technique provided essential structural support for inferomedial reconstructions, and the diced ADM-only technique achieved excellent results with reduced material requirements in superolateral locations. These findings provide preliminary evidence that may guide quadrant-specific ADM technique selection in OBCS, potentially enhancing aesthetic outcomes, patient satisfaction, and resource utilization. Full article

Introduction: Non-infectious erythema, or Red Breast Syndrome (RBS), has been observed on the skin where acellular dermal matrix was implanted, although the exact cause is yet to be determined. Patients and Methods: A total of 214 female patients underwent breast-conserving surgery (BCS) and volume replacement using diced acellular dermal matrix (dADM) for breast cancer between December 2017 and December 2018. After collecting and evaluating relevant clinical data, inflammation markers, along with NK cell status presented by IFN-γ secretion assay, were measured using ELISA. Results: Nineteen patients (8.88%) presented with RBS after BCS and dADM use. A significant increase of platelet-to-lymphocyte ratio was noted in the non-RBS group (p = 0.02). Compared to the RBS group (p = 0.042), the WBC level of the non-RBS group showed significant decrease over time. Eosinophil counts increased significantly at follow-up but went up higher in the RBS group. Multivariate analysis showed preoperative chemotherapy significantly increased the hazard of RBS (OR 3.274, p = 0.047 and OR 17.098, p < 0.001, respectively). Discussion: Though no causal relationship between RBS and immune status was proven, the results suggest an association between preoperative chemotherapy and RBS in addition to the possible role of eosinophilia in leading to eosinophilic dermatoses, which warrants further exploration and elucidation. Full article