Identification of risk factors in implant-based mesh supported breast reconstruction - results of the 2years follow up analysis of the PRO Bra Trial

Background Patient characteristics and cancer treatment may increase the risk for postoperative complications in breast reconstruction surgery. It is therefore essential to analyse those risk factors’ contribution to outcome of implant-based reconstruction.

Methods Primary or secondary implant-based breast reconstruction with support of synthetic non-resorbable titanized TiLOOP^® Bra surgical mesh was performed in 269 patients during the prospective, multicentre patient reported outcome (PRO)-BRA study (clinicaltrials.gov, NCT01885572, DRKS, DRKS00005342). Secondary endpoint was the evaluation of postoperative complication rates up to 24 months after breast reconstruction. Univariable and multivariable logistic regression analyses were performed to identify risk factors (e.g. BMI, age, radiotherapy, chemotherapy, implant size) increasing the risk for having complications.

Results Out of 362 breast reconstructions the following factors were identified in univariable logistic regression to be associated with increased risk for distinct complications: Implant size ≥ 75th percentile (>395 cm³) and BMI ≥ 25 kg/m² (first event, seroma, wound complications), adjuvant radiotherapy (capsular fibrosis), age ≥ 50 years (seroma), transverse/vertical incision (wound complications), and adjuvant chemotherapy (infection/inflammation). Multivariable logistic regression identified implant size ≥ 75th percentile (>395 cm³), neoadjuvant chemotherapy, and age ≥ 50 years as significant risk factors for the occurrence of the first complication.

Conclusion These specific identified risk factors must be taken into account in implant based to achieve a complication reduced postoperative outcome.

Publikationsverlauf

Artikel online veröffentlicht:
01. Juni 2021