J Breast Cancer.  2013 Mar;16(1):84-89.

The Suitability of Absorbable Mesh Insertion for Oncoplastic Breast Surgery in Patients with Breast Cancer Scheduled to Be Irradiated

• Kim T
• Cho H

Abstract

PURPOSE
The objective of this study was to investigate the influence of radiotherapy on the cosmetic outcome after immediate breast reconstruction using an absorbable mesh in breast cancer.
METHODS
From July 2008 to July 2009, 35 breast cancer patients who received immediate breast reconstruction with absorbable mesh insertion at the time of breast conserving surgery followed by radiotherapy were retrospectively studied.
RESULTS
In 91% of cases there was an excellent or good cosmetic outcome before the initiation of radiotherapy, and in 8.6% the outcome was fair at this point. However, 6 months after surgery and irradiation, the rate of excellent to good cosmetic outcomes had decreased to 60% and fair outcomes had increased to 25.7%. Contrary to the decreased rate of good cosmetic outcomes from 65.7% to 42.9% at 1 year after operation, the rate of fair to poor outcomes considerably increased from 8.6% to 57.1%. The significant factors affecting cosmetic outcomes were pathology, specimen volume, and the estimated percentage of breast volume excised (EPBVE). Chemotherapy affected the cosmetic outcome at borderline significance level. Age, breast volume tumor site, insertion of drain, radiation dose, and time elapsed between surgery and radiotherapy were not significantly associated with the cosmetic outcome.
CONCLUSION
Applying an absorbable mesh for the immediate reconstruction of the breast should be carefully considered in patients with an EPBVE of over 30% who are scheduled to be irradiated.

Keyword

Breast neoplasms; Segmental mastectomy; Surgical mesh; Radiotherapy

MeSH Terms

Breast
Breast Neoplasms
Cosmetics
Female
Humans
Mammaplasty
Mastectomy, Segmental
Retrospective Studies
Surgical Mesh
Surveys and Questionnaires
Cosmetics

Figure

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  Figure 1 Cosmetic outcomes and sonographic findings. (A, D) Good cosmetic outcome. Sonography indicated echogenic materials (in a 51-year-old woman with infiltrating ductal carcinoma [IDC] at 20 months after operation). (B, E) Fair cosmetic result showed mild asymmetry and nipple deviation, but no contracture. Sonography indicated parenchymal distortion (in a 42-year-old woman with IDC at 24 months after operation). (C, F) Poor cosmetic result was expressed by severe contracture, asymmetry and pain. Sonography indicated seroma (in a 54-year-old woman with IDC at 18 months after operation).

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