Risk factors for complications and implant loss after prepectoral implant-based immediate breast reconstruction: medium-term outcomes in a prospective cohort
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, ManchesterIssue Date
2021
Metadata
Show full item recordAbstract
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 SurgeryDOI
10.1002/bjs.11964PubMed ID
34043774Additional Links
https://dx.doi.org/10.1002/bjs.11964Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1002/bjs.11964
Scopus Count
Collections
Related articles
- Multicentre study of prepectoral breast reconstruction using acellular dermal matrix.
- Authors: Chandarana M, Harries S, National Braxon Audit Study Group
- Issue date: 2020 Feb
- Direct-to-Implant, Prepectoral Breast Reconstruction: A Single-Surgeon Experience with 201 Consecutive Patients.
- Authors: Safran T, Al-Halabi B, Viezel-Mathieu A, Boileau JF, Dionisopoulos T
- Issue date: 2020 Apr
- Acellular Dermal Matrix-sparing Direct-to-implant Prepectoral Breast Reconstruction: A Comparative Study Including Cost Analysis.
- Authors: Viezel-Mathieu A, Alnaif N, Aljerian A, Safran T, Brabant G, Boileau JF, Dionisopoulos T
- Issue date: 2020 Feb
- A Prospective Comparison of Short-Term Outcomes of Subpectoral and Prepectoral Strattice-Based Immediate Breast Reconstruction.
- Authors: Baker BG, Irri R, MacCallum V, Chattopadhyay R, Murphy J, Harvey JR
- Issue date: 2018 May
- Evolution of the Surgical Technique for "Breast in a Day" Direct-to-Implant Breast Reconstruction: Transitioning from Dual-Plane to Prepectoral Implant Placement.
- Authors: Antony AK, Poirier J, Madrigrano A, Kopkash KA, Robinson EC
- Issue date: 2019 Jun