J Breast Cancer.  2009 Mar;12(1):36-40. 10.4048/jbc.2009.12.1.36.

The Use of a Corrective Procedure with Vicryl Mesh for Oncoplastic Surgery of the Breast

• Eom TI
• Kim BS
• Koo BY
• Kim JW
• Lim YA
• Lee HH
• Lee SJ
• Kang HJ
• Kim LS

• KMID: 2286577
• DOI: http://doi.org/10.4048/jbc.2009.12.1.36

Abstract

PURPOSE: In addition to the oncological results, cosmetic results are very important to cancer patients. Currently, the use of oncoplastic surgery is an emerging approach. In this study, we examined the clinical outcomes of the use of a corrective procedure with an absorbable implant, a Vicryl mesh(R), as compared with the use of conventional breast conserving surgery (BCS).
METHODS
Fifty six patients who completed questionnaire were enrolled in the study. For 33 cases, BCS was performed concurrently with the use of a Vicryl mesh and for the other 23 cases, conventional BCS alone was performed. Contraindications of the use of corrective procedure were a patient age over 60 year, diabetes, neoadjuvant chemotherapy and a previous excisional biopsy performed on the same breast. Patients rated their cosmetic outcomes by use of a four point scale.
RESULTS
For one of 34 cases, the Vicryl mesh was removed due to infection and this patient was excluded from the study. Twenty seven of the remaining 33 patients (82%) who underwent the corrective procedure with Vicryl mesh were satisfied with their outcome. For patients that received conventional BCS only ten of 23 patients (43%) were satisfied with their outcome (p=0.05). Patient age, body mass index (BMI) and tumor location did not affect the cosmetic outcomes of the corrective procedure. When the resection area of the breast was 40-70 cm2, 88% of the patients were satisfied with their outcome.
CONCLUSION
This study suggested that the use of Vicryl mesh correction was superior to the use of conventional BCS alone for cosmesis. This method appears to provide a satisfactory outcome for oncoplastic surgery of the breast.

Keyword

Oncoplastic surgery; Vicryl mesh

MeSH Terms

Absorbable Implants
Biopsy
Body Mass Index
Breast
Cosmetics
Humans
Mastectomy, Segmental
Polyglactin 910
Surveys and Questionnaires
Cosmetics
Polyglactin 910

Figure

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  Figure 1 The method of making absorbable implant. (A) Vcryl mesh wrapped with Interceed® (7.6×10.2 cm). (B) Completion of absorbable implant.

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  Figure 2 The application of the absorbable implant. This absorbable implant was put into the dead space. And we fixed this material to the breast parenchyme with vicryl suture. To prevent surgical site infection, subcutaneous layer was closed very tightly.

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  Figure 3 The comparison between Vicryl mesh correction group with conventional BCS during radiation therapy. (A) Frontal view of the patient with conventional BCS. (B) Frontal view of the patient with Vicryl mesh. These patients received radiation therapy 6 months after surgery. There was no additional changes of breast contour during radiation therapy and no radiation skin ulcer at the vicryl mesh graft area.

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  Figure 4 Postoperative figures one year after surgery. (A) Frontal view of the patient with conventional BCS. (B) Frontal view of the patient with Vicryl mesh correction. All of these patients had been treated with adjuvant chemotherapy and radiation therapy. There was little displacement of nipple and areola in vicryl mesh correction case. And also, there was no significant skin dimpling in vicryl mesh correction case.

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