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    Risk factors for complications and implant loss after prepectoral implant-based immediate breast reconstruction: medium-term outcomes in a prospective cohort

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    Authors
    Dave, R. V.
    Vucicevic, A.
    Barrett, E.
    Highton, L.
    Johnson, R.
    Kirwan, Cliona C
    Harvey, J. R
    Murphy, J.
    Affiliation
    Nightingale Breast Centre, Manchester University Hospitals NHS Foundation Trust, Wythenshawe Hospital, Manchester
    Issue Date
    2021
    
    Metadata
    Show full item record
    Abstract
    Background: Prepectoral implant-based breast reconstruction with acellular dermal matrix has become an increasingly popular option for selected patients. There are no randomized data to demonstrate short- or long-term outcomes. Cohort studies to date have demonstrated safety, but risk factors for complications are unknown. Methods: A prospective cohort study of all patients undergoing prepectoral implant-based breast reconstruction between 2013 and 2019. Clinical factors and those related to reconstruction were analysed in relation to complications and implant loss using univariable and multivariable logistic regression. Results: A total of 469 reconstructions were undertaken in 289 women; the majority of reconstructions were performed using a one-stage direct-to-implant technique with acellular dermal matrix. Median follow-up was 21 (range 2-71) months. Minor complications were seen after 11·2 per cent of reconstructions, major complications after 5·9 per cent, and the rate of implant loss by 3 months was 3·1 per cent. In the final multivariable model, sentinel node biopsy (odds ratio (OR) 5·06, 95 per cent c.i. 2·00 to 12·80), axillary clearance (OR 6·67, 1·17 to 37·94) and adjuvant radiotherapy (OR 7·11, 1·60 to 31·61) were independent risk factors for development of a major complication, and sentinel node biopsy (OR 4·32, 1·23 to 15·22) for implant loss. Conclusion: Prepectoral implant-based breast reconstruction has acceptable medium-term results but careful patient selection is advised.
    Citation
    Dave RV, Vucicevic A, Barrett E, Highton L, Johnson R, Kirwan CC, et al. Risk factors for complications and implant loss after prepectoral implant-based immediate breast reconstruction: medium-term outcomes in a prospective cohort. The British journal of surgery. 2021;108(5):534-41.
    Journal
    British Journal of Surgery
    URI
    http://hdl.handle.net/10541/624131
    DOI
    10.1002/bjs.11964
    PubMed ID
    34043774
    Additional Links
    https://dx.doi.org/10.1002/bjs.11964
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1002/bjs.11964
    Scopus Count
    Collections
    All Paterson Institute for Cancer Research

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