Safety and Effectiveness of Acellular Dermal Matrix in Breast-Conserving Surgery for Breast Cancer: A Single-Institution Study
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: As breast-conserving surgery (BCS) has become the most common type of breast surgery, oncoplastic BCS has developed in response to improve cosmetic outcomes. Acellular dermal matrix (ADM) has been used as an adjunct to enhance cosmetic outcomes in partial breast reconstruction. This study aimed to evaluate postoperative complications, cosmetic satisfaction, and oncologic safety over a short-term follow-up period. Methods: This retrospective study included 26 patients who underwent BCS at Myongji Hospital between April 2019 and April 2021. All procedures were performed by three surgeons. We reviewed demographic data, histologic grades, tumor-node-metastasis stages, treatment modalities, and survival data based on patient medical records. Results: Of the 26 total patients, 5 developed seromas, which was the most common complication, and one patient experienced red breast syndrome. The incidence of complications per surgeon was less than 25%. The mean satisfaction score for the cosmetic outcome on a 10-point scale was 7.6 ( ± 2.1) as scored by patients and 8.8 ( ± 0.9) as scored by surgeons. Responses regarding cosmetic satisfaction revealed no significant differences among surgeons (<i>p</i>= 0.444). Of the 26 patients, four were lost to follow-up, and the mean follow-up period was 35.2 months. Two patients experienced recurrence, both of whom had regional recurrence with no local recurrence. Conclusion: ADM replacement is a favorable alternative to oncoplastic BCS, in terms of the ease of surgical procedures, minimal complications, and low rates of local recurrence.
Abstract
Purpose: As breast-conserving surgery (BCS) has become the most common type of breast surgery, oncoplastic BCS has developed in response to improve cosmetic outcomes. Acellular dermal matrix (ADM) has been used as an adjunct to enhance cosmetic outcomes in partial breast reconstruction. This study aimed to evaluate postoperative complications, cosmetic satisfaction, and oncologic safety over a short-term follow-up period. Methods: This retrospective study included 26 patients who underwent BCS at Myongji Hospital between April 2019 and April 2021. All procedures were performed by three surgeons. We reviewed demographic data, histologic grades, tumor-node-metastasis stages, treatment modalities, and survival data based on patient medical records. Results: Of the 26 total patients, 5 developed seromas, which was the most common complication, and one patient experienced red breast syndrome. The incidence of complications per surgeon was less than 25%. The mean satisfaction score for the cosmetic outcome on a 10-point scale was 7.6 ( ± 2.1) as scored by patients and 8.8 ( ± 0.9) as scored by surgeons. Responses regarding cosmetic satisfaction revealed no significant differences among surgeons (<i>p</i>= 0.444). Of the 26 patients, four were lost to follow-up, and the mean follow-up period was 35.2 months. Two patients experienced recurrence, both of whom had regional recurrence with no local recurrence. Conclusion: ADM replacement is a favorable alternative to oncoplastic BCS, in terms of the ease of surgical procedures, minimal complications, and low rates of local recurrence.
참고문헌 (20)
- Choi JE, "Breast cancer statistics in Korea, 2019", J Breast Cancer, 26, pp.207~220 (2023)
- Weber WP, "Standardization of oncoplastic breast conserving surgery", Eur J Surg Oncol, 43, pp.1236~1243 (2017)
- Noguchi M, "Oncoplastic breast conserving surgery : volume replacement vs. volume displacement", Eur J Surg Oncol, 42, pp.926~934 (2016)
- Kim H, "Acellular dermal matrix in the management of high-risk abdominal wall defects", Am J Surg, 192, pp.705~709 (2006)
- Lee JH, "Characterization and tissue incorporation of cross-linked human acellular dermal matrix", Biomaterials, 44, pp.195~205 (2015)
- Cuomo R, "Submuscular and pre-pectoral ADM assisted immediate breast reconstruction : a literature review", Medicina, 56, pp.256~ (2020)
- Franceschini G, "Acellular dermal matrix as filler in breast-conserving surgery : warnings for a careful use", World J Surg Oncol, 19, pp.1~ (2021)
- Paprottka FJ, "Evaluation of complication rates after breast surgery using acellular dermal matrix : median follow-up of three years", Plast Surg Int, 2017, pp.1283735~ (2017)
- Ortiz JA, "Clinical outcomes in breast reconstruction patients using a sterile acellular dermal matrix allograft", Aesthetic Plast Surg, 41, pp.542~550 (2017)
- Lewis P, "Reducing postoperative infections and red breast syndrome in patients with acellular dermal matrix-based breast reconstruction : the relative roles of product sterility and lower body mass index", Ann Plast Surg, 74(Suppl 1), pp.S30~S32 (2015)
- Podsednik Gardner A, "Red breast syndrome and acellular dermal matrix", Plast Reconstr Surg Glob Open, 11, pp.e5062~ (2023)
- Sarkozyova N, "Preparation and processing of human allogenic dermal matrix for utilization in reconstructive surgical procedures", Bratisl Med J, 121, pp.386~394 (2020)
- Selber JC, "Critical evaluation of risk factors and early complications in 564 consecutive two-stage implant-based breast reconstructions using acellular dermal matrix at a single center", Plast Reconstr Surg, 136, pp.10~20 (2015)
- Valdatta L, "Acellular dermal matrices and radiotherapy in breast reconstruction : a systematic review and meta-analysis of the literature", Plast Surg Int, 2014, pp.472604~ (2014)
- Moyer HR, "The effect of radiation on acellular dermal matrix and capsule formation in breast reconstruction : clinical outcomes and histologic analysis", Plast Reconstr Surg, 133, pp.214~221 (2014)
- Macadam SA, "Acellular dermal matrices : use in reconstructive and aesthetic breast surgery", Can J Plast Surg, 20, pp.75~89 (2012)
- An J, "The comparison of breast reconstruction using two types of acellular dermal matrix after breast-conserving surgery", J Clin Med, 10, pp.3430~ (2021)
- Gwak H, "Volume replacement with diced acellular dermal matrix in oncoplastic breast-conserving surgery : a prospective single-center experience", World J Surg Oncol, 18, pp.60~ (2020)
- Panayi AC, "Patient-reported outcomes utilizing the Breast-Q questionnaire after breast conserving surgery with and without oncoplastic breast surgery : a systematic review and meta-analysis", Aesthet Surg J, pp.sjae002~ (2024)
- Kim MY, "Imaging surveillance for the detection of ipsilateral local tumor recurrence in patients who underwent oncoplastic breast-conserving surgery with acellular dermal matrix : abbreviated MRI versus conventional mammography and ultrasonography", World J Surg Oncol, 19, pp.290~ (2021)