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Is a soft tissue reinforcing mesh necessary in immediate prosthetic breast reconstruction for early breast cancer in patients with low-volume breast? A single-center, retrospective Chinese clinical study

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Abstract

It is controversial as to whether soft tissue reinforcement mesh should be used for immediate prosthetic breast reconstruction after nipple-sparing mastectomy for low-volume breast early breast cancer (LVBEBC) in Chinese adult women. We collected data on 89 patients with LVBEBC who underwent such a surgery and divided them into two groups: 39 patients in the totally subpectoral prosthesis-only breast reconstruction group (simple group) and 50 patients in the prosthesis-combined titanium-coated polypropylene mesh (TCPM) group (or the so-called "dual plane" or "mesh-assisted partially subpectoral breast reconstruction group") (combined group). The results demonstrated no difference in operative time, intraoperative bleeding, and postoperative complications between the two groups; however, total drainage volume and extubation time were less and shorter, respectively, in the combined group. The median follow-up time was 18.6 months without local recurrence or distant metastasis in both groups. At 24 months after surgery, the excellent and good rates of breast reconstruction were higher in the combined group. However, patients' BMI, breast morphology, and breast volume of 300 mL or more had an effect on the shape of the reconstructed breast; in addition, in patients with higher BMI, conical breast morphology, and breast volume over 300 mL, the shape of the breast was more perfect with the prosthesis combined with TCPM reconstruction.

Trial registration: This retrospective study was "retrospectively registered" in the Sixth Affiliated Hospital of South China University of Technology of China on March 15, 2022 (No. 2022018) and in the National Medical Research Registry filing system of China (https://www.medicalresearch.org.cn) (No. MR-44-22-003618).

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Data availability

The data sets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

Not applicable.

Funding

This study was supported by the Chinese Guangdong Fund for Basic and Applied Basic Research-Regional Joint Fund Projects (Key Projects, No. 21201910250000517), the Medical Science and Technology Tackling Project of Foshan Science and Technology Bureau of China (No. 2220000004005), the Medical Research Project of Foshan Health and Family Planning Bureau of China (No. 20190260), and the Foshan High-level Medical Talent Training Fund of China (No. 2018B015).

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Author notes

  1. Huangyun Yang and Ziyun Guan are Co-first authors.

Authors and Affiliations

  1. Department of Breast Surgery, Sixth Affiliated Hospital of South China University of Technology, and Sixth Clinical College of South China University of Technology, No.120 Guidan Road, Nanhai District, Foshan, 528225, Guangdong, People’s Republic of China

    Chengcai Yao, Changchun Liu, Jiayi Xian, Ming Chen & Wenjian Huang

  2. Xiamen Maternal and Child Health Hospital, Xiamen University Women and Children’s Hospital of China, Xiamen, 361000, People’s Republic of China

    Huangyun Yang

  3. Sixth Affiliated Hospital of South China University of Technology, Foshan, 528200, People’s Republic of China

    Ziyun Guan

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Contributions

The article was mainly written by CY, HY, CL, JX, MC and WH. CY, CL, JX, MC and WH performed the surgical study. The entire study was supervised by CY. ZG was mainly responsible for English editing, including English spelling, grammar and sentence patterns. HY, MC, JX and CL assisted in the data analysis and manuscript editing.

Corresponding author

Correspondence to Chengcai Yao.

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Conflict of interest

The authors declare no competing interests.

Consent for publication

The clinical data that were used in this study were authorized by each patient and were authorized to be publicly published.

Ethics approval

The study protocol was approved by the Sixth Affiliated Hospital of South China University of Technology (SCUT) and Sixth Clinical College of SCUT of China (No. 2022022, Date: 2022.03.21).

Informed consent

Informed consent was obtained from all of the individual participants who were included in the study.

Research involving human participants and/or animals

This was a retrospective study with hospital ethics committee approval and informed consent from the subjects. It does not address the issues you raise.

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Yao, C., Yang, H., Guan, Z. et al. Is a soft tissue reinforcing mesh necessary in immediate prosthetic breast reconstruction for early breast cancer in patients with low-volume breast? A single-center, retrospective Chinese clinical study. Updates Surg 75, 2005–2015 (2023). https://doi.org/10.1007/s13304-023-01585-6

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