In recent years, considerable success has been achieved in complex and combined treatment of breast cancer (BC). Reconstructive plastic surgery plays an important role in the rehabilitation of patients with breast cancer and it is currently considered as the causal treatment of mental disorders caused by loss of femininity and integrity of one’s own body. One-step breast reconstruction for cancer treatment makes it possible to use supplementary materials – synthetic and biological implants that can replace muscle autografts and thereby reduce trauma, blood loss, operation time, they help to avoid the defect of donor areas. The authors describe the state of the art at present and demonstrate the results of their own research.
From 2013 to 2018, 104 implant-based immediate reconstructive operations with mesh (N = 80) and ADM (N = 24) were performed in breast cancer patients after subcutaneous or skin-sparing, nipple-sparing mastectomies. The average age of patients is 47, 2 years old. Stage 0 of BC was diagnosed in 2% of patients, I – 30%, IIA – 33%, IIB – 16%, IIIA – 15%, IIIB – 2%, IIIC – 2%. Titanium meshes were used in 12 cases and polyester 3D meshes in 68 cases. The size of Implants ranged from 120 to 585 sm3.
Cosmetic result was rated as excellent in 67,3% cases, good in 19,2%, satisfactory in 7,7%, as very bad in 5,8%. The frequency of implant loss was 5,8% when titanium breast mesh was used and 0% with polyester mesh. Seroma was diagnosed in 1,9% when using pork ADM and 2,9% when using titanium mesh. Necrosis of a nipple was in 1,9% when using titanium mesh. Infection of the implant was recorded in 2,9% cases. A capsular contracture developed in 5,8% cases after radiotherapy.
Biological and synthetic materials are significantly important options for breast reconstruction. They are adequate substitutes for autologous muscle flaps if the patients for the operation are properly select.
The P.A. Herzen Moscow Cancer Research Institute – The Branch of the Federal State Budgetary Institution «National Medical Radiological Research Center» at the Ministry of Health Care of the Russian Federation.
Has not received any funding.
All authors have declared no conflicts of interest.