Trends in post-mastectomy breast reconstruction types at a breast cancer tertiary referral centre before and after introduction of acellular dermal matrices

Kankam, Hadyn K. N. and Hourston, George J. M. and Fopp, Laura J. and Benson, John R. and Benyon, Sarah L. and Irwin, Michael S. and Agrawal, Amit and Forouhi, Parto and Malata, Charles M. (2018) Trends in post-mastectomy breast reconstruction types at a breast cancer tertiary referral centre before and after introduction of acellular dermal matrices. Journal of Plastic, Reconstructive & Aesthetic Surgery, 71 (1). pp. 21-27. ISSN 1878-0539

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Official URL: https://doi.org/10.1016/j.bjps.2017.08.016

Abstract

Background: Reconstructive breast surgery has continued to evolve over the last decade with a key change being the adoption of acellular dermal matrices (ADMs) as an adjunct for implant-based procedures. This retrospective observational study assesses the effect of ADMs on post-mastectomy reconstructive practice performed in a single institution. Methods: We conducted a review of all patients undergoing breast reconstruction at a University Teaching Hospital for an 18-month period before and after adopting ADMs. Demographic, procedural and complication data for these two cohorts were compared (χ2 and Student's t-tests). Results: A total of 264 women (336 breasts), mean age 47.5 years, were identified: 137 before and 127 after the introduction of ADM. Implant-only reconstructions increased from 16% to 52% following the adoption of ADM (p < 0.01), whereas the proportion of both latissimus dorsi and deep inferior epigastric perforator flap reconstructions decreased significantly (31%–11% and 49%–34%, respectively, p < 0.01). The rate of early complications for the implant-only procedures was not significantly different with or without ADM (26% versus 20%, respectively, p = 0.44), despite there being no difference in the rate of adjuvant radiotherapy (22% versus 35%, respectively, p = 0.30). Conclusions: This study showed that since ADM introduction to our centre, more breast reconstructions have been of the implant-only type with consequent reductions in the more complex and expensive autologous techniques. Implant-only procedures that incorporated ADM use had similar complication rates to those that did not.

Item Type: Journal Article
Keywords: Immediate breast reconstruction, Acellular dermal matrix, Trends, Outcomes
Faculty: ARCHIVED Faculty of Medical Science (until September 2018)
Depositing User: Lisa Blanshard
Date Deposited: 08 Jan 2018 16:00
Last Modified: 10 Oct 2019 16:12
URI: http://arro.anglia.ac.uk/id/eprint/702602

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