Outcomes of breast conserving surgery with immediate vicryl-mesh insertion: is it safe and effective?

Although breast-conserving surgery (BCS) has become a standard for breast-cancer surgery with improved cosmetic outcomes, there have been many attempts to achieve superior results. Vicryl-mesh insertion, one such method, is a simple technique involving a relatively short period of time. However, doubts regarding its safety and efficacy remain. Therefore, we attempted to analyze the aesthetic outcomes, patient satisfaction, and safety with respect to Vicryl mesh. From May 2007 to March 2009, 38 patients underwent BCS with immediate Vicryl-mesh insertion at Ewha Womans University Mokdong Hospital, Seoul, Korea. In the same period, 31 patients who underwent BCS for breast cancer were randomly selected as a control group. Five patients who underwent BCS with Vicryl-mesh insertion were excluded because they were lost to follow-up shortly after surgery. Retrospective analysis of patient records and oral interviews were performed. We analyzed patients' overall satisfaction, postoperative satisfaction with breast shape, pain, and postoperative complications in the two groups. The mean age, body mass index, follow-up period, specimen size, and ratio of benign to malignant tumors did not differ significantly between the two groups. With regard to tumor location, more tumors were in the upper and lower inner portions of the breast among patients who underwent BCS with Vicryl mesh. There were no significant differences in overall satisfaction or satisfaction with breast shape (p > 0.05), but differences in pain scores were significant (p = 0.016). In terms of the complication rate, four cases with complications (11.8%) were observed in the Vicryl-mesh group and no complications in the BCS-only group. Vicryl-mesh insertion showed a higher complication rate and no cosmetic gain. Therefore, we believe that Vicryl-mesh insertion should be performed carefully. In addition, studies involving many more cases and longer follow-up periods are needed.