Long-term Outcomes of Acellular Dermal Matrix Use in Breast-Conserving Surgery: A Single-Institution Study

This study evaluated long-term postoperative outcomes and complications after breast-conserving surgery (BCS) with acellular dermal matrix (ADM) insertion.

We retrospectively reviewed the data of patients treated between July 2015 and August 2021. Patients who did not undergo postoperative follow-up were excluded. Clinical characteristics, treatment information, and postoperative complications were collected from the electronic medical records. Complications were classified as major (requiring hospitalization or surgical intervention) or minor (manageable in an outpatient setting). ADM removals were categorized as early (≤ 6 months postoperatively) or delayed (> 6 months).

Among the 236 patients (median follow-up, 71.7 months), complications occurred in 119 (50.4%): 22 major (9.3%) and 97 minor (41.1%). Infection was the most common major complication (13/22, 59.2%), whereas seroma was the predominant minor complication (87/97, 89.7%). In univariate analysis, no clinicopathological or treatment-related factors were associated with major complications. ADM removal was performed in 28 patients (11.9%), including nine with local recurrence and 19 unrelated to recurrence (8.1%). Among the 19 nonrecurrent removals, 13 (68.4%) occurred > 6 months after surgery, most commonly due to infection (12/19, 63.2%).

Complications after BCS with ADM insertion were common during the long-term follow-up. The 9.3% major complication rate and 8.1% reoperation rate for ADM removal are not negligible. These findings highlight the need for careful patient selection and long-term surveillance of patients undergoing BCS with ADM insertion.