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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
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Surgical and Patient-Reported Outcomes After Mastectomy and Implant-Based Prepectoral Reconstruction Using TIGR®
Shiveta Razdan1,2, Goran A Ahmed2, Gayatri Vishwakarma3
1Breast Surgery, Amrita Institute of Medical Science and Research, Faridabad, IND.
Cureus
|June 25, 2024
Summary
Direct-to-implant breast reconstruction using TIGR mesh is safe and effective, showing low complication rates and good patient-reported outcomes. This synthetic mesh offers a viable option for immediate breast reconstruction after mastectomy.
Area of Science:
- Plastic Surgery
- Oncology
- Biomaterials
Background:
- Direct-to-implant (DTI) breast reconstruction is increasingly popular, utilizing biological matrices and synthetic meshes.
- Evidence for superior outcomes with biological matrices over synthetic meshes is lacking.
- TIGR mesh, a synthetic, long-term absorbable option, warrants evaluation in mastectomy and immediate breast reconstruction (MIBR).
Purpose of the Study:
- To evaluate the safety and patient-reported outcomes of TIGR mesh in prepectoral MIBR.
- To assess complication rates, including infection, flap necrosis, and implant loss.
- To analyze patient-reported outcome measures (PROMs) using the EORTC breast questionnaire.
Main Methods:
- Prospective quality improvement study (2017-2019) involving 93 patients (112 meshes).
- TIGR mesh used for prepectoral MIBR in cancer or risk reduction cases.
- Clinical evaluation at 1 week, 3 weeks, and 12 months; PROMs collected via EORTC questionnaire.
Main Results:
- Complications occurred in 26% of patients, including infection (4.3%) and implant loss (4.3%).
- Patient-reported outcomes showed moderate overall quality of life (82.7%), high functional scores, and lower emotional functioning scores.
- Symptom domains scored poorly, except for body image and sexual functioning.
Conclusions:
- Mastectomy and immediate prepectoral breast reconstruction with TIGR mesh demonstrate safety and low major complication rates.
- The procedure is associated with favorable functional and quality of life scores.
- Lower scores in symptom domains may be multifactorial; further research with longer follow-up is suggested.
