Yonsei Med J.  2011 Sep;52(5):803-808. 10.3349/ymj.2011.52.5.803.

Results from Over One Year of Follow-Up for Absorbable Mesh Insertion in Partial Mastectomy

• Koo MY
• Lee SK
• Hur SM
• Bae SY
• Choi MY
• Cho DH
• Kim S
• Choe JH
• Kim JH
• Kim JS
• Lee JE
• Nam SJ
• Yang JH

• KMID: 1108074
• DOI: http://doi.org/10.3349/ymj.2011.52.5.803

Abstract

PURPOSE
Recently, several clinicians have reported the advantages of simplicity and cosmetic satisfaction of absorbable mesh insertion. However, there is insufficient evidence regardint its long-term outcomes. We have investigated the surgical complications and postoperative examination from the oncologic viewpoint.
MATERIALS AND METHODS
From February 2008 to March 2009, 34 breast cancer patients underwent curative surgery with absorbable mesh insertion in Samsung Medical Center. Patient characteristics and follow up results including complications, clinical and radiological findings were retrospectively investigated.
RESULTS
The mean age of the study population was 50.1+/-8.9 years old (range 31-82) with a mean tumor size of 3+/-1.8 cm (range 0.8-10.5), and the excised breast tissue showed a mean volume of 156.1+/-99.8 mL (range 27-550). Over the median follow-up period of 18+/-4.6 months (range 3-25), mesh associated complications, including severe pain or discomfort, edema, and recurrent fluid collection, occurred in nine patients (26.5%). In three cases (8.8%), recurrent mastitis resulted in mesh removal or surgical intervention. In the postoperative radiologic survey, the most common finding was fluid collection, which occurred in five patients (16.1%), including one case with organizing hematoma. Fat necrosis and microcalcifications were found in three patients (9.7%).
CONCLUSION
Absorbable mesh insertion has been established as a technically feasible, time-saving procedure after breast excision. However, the follow-up results showed some noticeable side effects and the oncologic safety of the procedure is unconfirmed. Therefore, we suggest that mesh insertion should be considered only in select cases and should be followed-up carefully.

Keyword

Breast neoplasms; mastectomy; segmental; absorbable implants

MeSH Terms

Adult
Aged
Aged, 80 and over
Edema/etiology
Female
Follow-Up Studies
Granuloma, Foreign-Body/etiology/ultrasonography
Humans
Mammaplasty/adverse effects/methods
Mastectomy, Segmental/adverse effects/*methods
Mastitis/etiology
Middle Aged
Pain/etiology
Postoperative Complications/etiology
Retrospective Studies
*Surgical Mesh/adverse effects

Figure

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  Fig. 1 Mammographic findings after mesh insertion (A) various shapes of mass densities (arrow) were found, ranging from mild skin dimpling to heterogeneous mass densities. (B) Microcalcifications suggesting fat necrosis (circle) were found at the operation site.

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  Fig. 2 Ultrasound findings after mesh insertion (A) Well-circumscribed cyst and ovoid shape nodules suggest granulomatous reaction to foreign body. (B) Ill-defined, irregular margined mass or extra-cavity lesions (arrows) may mimic local recurrence.

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