Breast Cancer

Biography

Biography: Gianluca Franceschini

Abstract

Immediate Prosthetic Breast Reconstruction (IPBR) is considered as an integral part of the surgical treatment of patients undergoing Nipple-Sparing Mastectomy (NSM) for breast cancer, as it positively affects psychological health, sexuality, body image, and self-esteem.

Traditionally, IPBR has been performed by placement of the prosthetic implant in a Sub Muscular (SM) pocket created beneath the pectoralis major muscle, in order to protect the integrity of the implant and reduce its visibility and palpability. Although this technique has shown increasingly good results, it still yields a higher risk of undesirable outcomes such as significant postoperative pain, injury-induced muscular deficit, breast animation deformity, lateral deviation of the breast mound with poor inframammary fold definition, and insufficient lower pole fullness.

In recent years, placement of the implant in a prepectoral (PP) plane has been increasingly employed. When this technique is performed, the implant is usually covered with an Acellular Dermal Matrix (ADM) to shield it in the subcutaneous space underneath the skin flaps; however, the use of ADM has been reported to increase risks of seroma, infection, and skin/nipple-areola complex (NAC) necrosis, and associated with higher medical costs. To limit these inconveniences, the use of implants with a special micropolyurethane-foam-coated shell surface (microthane) that does not require ADM coverage has recently been proposed.

The aim of this study was to compare outcomes between traditional SM-IPBR and a PP technique using microthane implants without ADMs in patients undergoing NSM.