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Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Locally Advanced Breast Cancer: Autologous Versus Implant-based Reconstruction
Grigorios Tanos1, Elena Prousskaia1, Whitney Chow1
1Department of Plastic Surgery, Southmead Hospital, North Bristol NHS Foundation Trust, Bristol, United Kingdom; Department of Plastic Surgery, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; University of Manchester, Manchester, United Kingdom; and Department of Breast Surgery, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
For locally advanced breast cancer (LABC) patients, autologous tissue reconstruction (ATR) shows lower failure rates than implant-based reconstruction (IBR), despite similar complication risks and adjuvant therapy delays. Careful consideration of implants is advised.
Area of Science:
- Oncology
- Plastic Surgery
- Breast Cancer Research
Background:
- Guidelines recommend breast reconstruction for locally advanced breast cancer (LABC) patients.
- The optimal reconstruction method for LABC remains controversial.
Purpose of the Study:
- To compare outcomes of different breast reconstruction methods in LABC patients.
- To evaluate implant-based/expander-based reconstruction (IBR) versus autologous tissue reconstruction (ATR).
Main Methods:
- A retrospective study of 114 LABC patients (2007-2013) divided into no reconstruction (NR), IBR, and ATR groups.
- Analysis of demographics, adjuvant therapy delay, hospitalization, complications, reconstruction failure, local recurrence, and survival.
Main Results:
- No significant difference in adjuvant therapy delay between groups.
- Hospital stays: NR (2.7 days), IBR (6 days), ATR (7.5 days).
- Reconstruction failure rates: IBR (37%) vs. ATR (0%). Local recurrence: NR (7%) vs. IBR/ATR (2%). Survival varied.
- IBR had high implant removal rates (37%) due to complications.
Conclusions:
- Implant-based reconstruction (IBR) in LABC patients is associated with high failure rates.
- Autologous tissue reconstruction (ATR) demonstrates superior outcomes regarding reconstruction success.
- No significant differences in complication rates or adjuvant therapy delays were observed between IBR and ATR.
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