O-74 Comparison of the incidence of severe capsular contracture following implant-based immediate breast reconstruction with or without postoperative chest wall radiotherapy using 40 Gy in 15 fractions

2007 ◽  
Vol 5 (3) ◽  
pp. 23 ◽  
Author(s):  
G.A. Whitfield ◽  
G. Horan ◽  
M.S. Irwin ◽  
C.M. Malata ◽  
G.C. Wishart ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Chest Wall ◽  
Capsular Contracture ◽  
Immediate Breast Reconstruction

scholarly journals Acellular dermal matrices in immediate breast reconstruction: a literature review

2021 ◽  
Vol 8 (2) ◽  
pp. 933
Author(s):  
Mohammed Attallah Alharbi ◽  
Fahad K. Aljindan ◽  
Reshan Mane Al Reshan ◽  
Khalid Dakhelallah Almutairi ◽  
Fatimah Mofeed Almosabh ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Reconstructive Surgery ◽  
Capsular Contracture ◽  
Acellular Dermal Matrix ◽  
Immediate Breast Reconstruction ◽  
Dermal Matrix ◽  
Different Types ◽  
Dermal Matrices ◽  
Breast Reconstructive Surgery ◽  
Acellular Dermal

There has been an increase in invasive breast carcinoma which many times end up with a mastectomy. The psychological effects of mastectomy can be overwhelming, urging the need for optimum breast reconstruction procedures. Acellular dermal matrices are widely used nowadays due to their favorable outcomes with a few complications. In this study, we review the literature to explore the different types used, cons, and pros of this procedure. Databases like PubMed, Medline, Web of science, Embase, Google scholar, and Scopus were used and searched for following terms “implant-based reconstruction” or “breast reconstruction” or “acellular dermal matrix”. All studies that discuss the use of acellular dermal matrices for breast reconstructive surgery were included. Acellular dermal matrices may allow a relatively easy, affordable and time-efficient breast reconstructive surgery. They are associated with less incidence of infection and capsular contracture making them an excellent fit for most procedures. However, m ore studies are needed to help understand possible risk factors, and complications and how to avoid them.

scholarly journals 1443 Comparison of Outcomes Between Immediate Direct-to-Implant Breast Reconstruction versus Two-Stage Implant Breast Reconstruction; a Systematic Review and Meta-analysis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
O Kelly ◽  
I Balasubramanian ◽  
C Cullinane ◽  
R Prichard
Keyword(s):  
Systematic Review ◽  
Breast Reconstruction ◽  
Meta Analysis ◽  
Capsular Contracture ◽  
Tissue Expander ◽  
Immediate Breast Reconstruction ◽  
Two Stage ◽  
Significant Difference ◽  
Implant Reconstruction ◽  
Implant Breast Reconstruction

Abstract Background Direct-to-implant (DTI) breast reconstruction is increasingly performed as the preferred method of immediate breast reconstruction following mastectomy. The proposed advantages of DTI over two-stage tissue expander (TE)/implant reconstruction relate to fewer surgical procedures. This systematic review and meta-analysis aims to evaluate the safety and efficacy of DTI versus conventional TE/implant breast reconstruction. Method A systematic review was performed (PubMed, Embase, Scopus) to identify relevant studies that compared outcomes between DTI and TE/Implant reconstructions. Publications up to October 2020 were included. The primary outcome was overall complication rate. Secondary outcomes included infection rate and implant loss. Results Nineteen studies, including 32,971 implant-based breast reconstructions, were analysed. Median age was 48 years. Mean BMI was 25.9. There was no statistically significant difference between the two groups. Duration of follow up ranged from 1-60 months. Overall complications were significantly more likely to occur in the DTI group (OR 1.81 [1.17-2.79]). Overall complications refers to all reported complications including seroma, haematoma, would dehiscence, infection, skin necrosis and capsular contracture. Implant loss was also significantly higher in the DTI cohort (OR 1.31 [1.12-1.78]). There was no significant difference in infection rates between the two groups. Subgroup analyses, focusing on high-powered multicentre studies showed that the risks of overall complications were significantly higher in the DTI group (OR 1.51 [1.06-2.14]). Conclusions This meta-analysis demonstrates significantly greater risk of complications and implant loss in the DTI breast reconstruction group. These findings serve to aid both patients and clinicians in the decision-making process regarding implant reconstruction following mastectomy

Postmastectomy Radiation of Latissimus Dorsi Myocutaneous Flap Reconstruction is Well Tolerated in Women with Breast Cancer

2012 ◽  
Vol 78 (10) ◽  
pp. 1122-1127 ◽  
Author(s):  
Brandice Durkan ◽  
Farin Amersi ◽  
Edward H. Phillips ◽  
Randy Sherman ◽  
Catherine M. Dang
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Chest Wall ◽  
Latissimus Dorsi ◽  
Myocutaneous Flap ◽  
Immediate Breast Reconstruction ◽  
Bilateral Mastectomy ◽  
Wound Complications ◽  
Postmastectomy Radiation ◽  
Latissimus Dorsi Myocutaneous Flap

Chest wall irradiation decreases locoregional recurrence and breast cancer-related mortality in women at high risk for recurrence after mastectomy. Many women undergoing mastectomy desire immediate breast reconstruction. Postmastectomy radiation therapy (PMRT), however, increases the risk of surgical complications and may adversely affect the reconstructed breast. We compared outcomes of immediate latissimus dorsi myocutaneous flap (Lat Flap) versus tissue expander/implant (EI) reconstruction after mastectomy followed by PMRT in 29 women with invasive breast cancer treated at a single institution between 2009 and 2011. Although patients undergoing EI reconstruction were slightly younger and more frequently underwent bilateral mastectomy, there were no major differences between the groups with respect to patient or tumor characteristics. With a median follow-up of 11 months (Lat Flap) and 13 months (EI) after completion of PMRT, there was a trend toward more wound complications requiring reoperation, including expander/implant loss (n = 3), in the EI group. Capsular contracture was the most common sequela of PMRT in the Lat Flap group (67%) but this was easily treated with capsulotomy at the time of nipple– areola reconstruction. Immediate breast reconstruction with a latissimus dorsi myocutaneous flap is a viable option for women undergoing mastectomy who are likely to require chest wall irradiation.

scholarly journals Does chemotherapy or radiotherapy affect the postoperative complication in patients who underwent immediate breast reconstruction with tissue expander?

2020 ◽  
Author(s):  
Sung Mi Jung ◽  
Byung-Joon Jeon ◽  
Jinsun Woo ◽  
Jai Min Ryu ◽  
Se Kyung Lee ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Postoperative Complications ◽  
Breast Reconstruction ◽  
Capsular Contracture ◽  
Univariate Analysis ◽  
Tissue Expander ◽  
Immediate Breast Reconstruction ◽  
Surgical Removal ◽  
The Impact ◽  
To Receive

Abstract Background: Immediate breast reconstruction with tissue expander in patients who were expected to receive adjuvant therapy, such as chemotherapy or radiotherapy, has been a topic of debate. Postoperative complications from tissue expander procedures can delay the timing of adjuvant treatment and subsequently increase the probability of recurrence. The purpose of this study was to identify the impact of chemotherapy and radiotherapy on postoperative complications in patients who underwent immediate reconstruction (IR) using tissue expander.Methods: We conducted a retrospective study of 1,081 breast cancer patients who underwent mastectomy and IR using tissue expander insertion between 2012 and 2017 in Samsung Medical Center. The patients were divided into two groups based on complications (complication group vs. no complication group). Complication group was regarded to have surgical removal or conservative treatment based on clinical findings such as infection, capsular contracture, seroma, hematoma, rupture, malposition, tissue viability, or cosmetic problem. The complication group had 59 patients (5.5%) and the no complication group had 1,022 patients (94.5%). Results: In univariate analysis, adjuvant radiotherapy and adjuvant chemotherapy were significantly associated with postoperative complications. In multivariate analysis, however, only higher pathologic N stage was significantly associated with postoperative complications (p < 0.001). Chemotherapy (p = 0.775) or radiotherapy (p = 0.825) were not risk factors for postoperative complications.Conclusions: IR with tissue expander after mastectomy may be a treatment option even when the patients are expected to receive adjuvant chemotherapy or radiotherapy. These results will aid patients who are concerned about the complications of IR caused by chemotherapy or radiotherapy determine whether or not to have IR.

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