CC BY-NC-ND 4.0 · Indian J Plast Surg 2024; 57(05): 372-378
DOI: 10.1055/s-0044-1787059
Original Article

Breast Cancer Local Recurrence Risk in Implant-Based Breast Reconstruction with Macrotexturized and Microtexturized Prosthesis: A Multicentric Retrospective Cohort Study

Valeriano Vinci
1   Department of Biomedical Sciences, Humanitas University, Milan, Italy
2   Department of Plastic and Reconstructive Surgery, Humanitas Clinical and Research Center-IRCCS, Milan, Italy
,
Francesco Klinger
3   Department of Health Sciences, Ospedale San Paolo, University of Milan, Milan, Italy
,
Riccardo Di Giuli
4   Department of Medical Biotechnology and Translational Medicine BIOMETRA, Plastic Surgery Unit, Reconstructive and Aesthetic Plastic Surgery School, Humanitas Clinical and Research Hospital, University of Milan, Milan, Italy.
,
Andrea Vittorio Emanuele Lisa
2   Department of Plastic and Reconstructive Surgery, Humanitas Clinical and Research Center-IRCCS, Milan, Italy
,
Barbara Catania
4   Department of Medical Biotechnology and Translational Medicine BIOMETRA, Plastic Surgery Unit, Reconstructive and Aesthetic Plastic Surgery School, Humanitas Clinical and Research Hospital, University of Milan, Milan, Italy.
,
Stefano Vaccari
4   Department of Medical Biotechnology and Translational Medicine BIOMETRA, Plastic Surgery Unit, Reconstructive and Aesthetic Plastic Surgery School, Humanitas Clinical and Research Hospital, University of Milan, Milan, Italy.
,
Edoardo Caimi
1   Department of Biomedical Sciences, Humanitas University, Milan, Italy
,
Emanuele Pitassi
5   Department of Biomedical Sciences, University of Milan, Milan, Italy
,
Jacopo Di Filippo
5   Department of Biomedical Sciences, University of Milan, Milan, Italy
,
Damiano Gentile
6   Breast Unit, IRCCS Humanitas Research Hospital, Milan, Italy
,
Corrado Tinterri
6   Breast Unit, IRCCS Humanitas Research Hospital, Milan, Italy
,
Gerardus Johannes Janszen
7   Department of Aerospace Science and Technology, Politecnico of Milan, Milan, Italy
,
Marco Klinger
4   Department of Medical Biotechnology and Translational Medicine BIOMETRA, Plastic Surgery Unit, Reconstructive and Aesthetic Plastic Surgery School, Humanitas Clinical and Research Hospital, University of Milan, Milan, Italy.
› Author Affiliations

Abstract

Background Nowadays, implant-based breast reconstruction is a common technique after mastectomy. The widespread use of implant employment is prompting significant concerns regarding the oncological safety of prostheses and the potential impact of surface texture on the recurrence of local breast cancer. This article examines the oncological outcomes associated with postmastectomy breast reconstructions using micro- and macrotexturized implants, focusing on the incidence and relative risk (RR).

Materials and Methods A retrospective cohort study was conducted on patients admitted to Multimedica group (IRCCS, San Giovanni Hospital, Milan) and ICH groups (Humanitas Clinical Institute, Milan) between January 2003 and September 2020. Minimum follow-up considered was of 1 year.

Patients submitted to either complete or nipple-spearing mastectomy, who underwent breast reconstruction with macrotexturized or microtexturized prosthesis, were included in group A and B, respectively.

Results A total of 646 patients met the basic inclusion and exclusion criteria. Group A included 410 (63.5%) patients and group B included 236 (36.5%). Cancer recurrence absolute risk in group A was 5.6 ± 2.2% and in group B was of 2.1 ± 1.8%. RR for breast cancer recurrence in group A compared to group B was of 2.65; confidence interval 95% (1.02; 6.87). Statistical analysis identified a higher local recurrence risk in patients reconstructed with macrotexturized prosthesis (p-value 0.036).

Conclusion This study detected a higher risk for local breast cancer recurrence associated to macrotexturized breast implants employment. Further investigations are required to verify these outcomes.



Publication History

Article published online:
30 May 2024

© 2024. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 World Health Organization. Breast Cancer. Accessed August 18, 2022 at: https://www.who.int
  • 2 Ahmad A. Breast cancer statistics: recent trends. Adv Exp Med Biol 2019; 1152: 1-7
  • 3 Sancho-Garnier H, Colonna M. Breast cancer epidemiology [in French]. Presse Med 2019; 48 (10) 1076-1084
  • 4 Peart O. Breast intervention and breast cancer treatment options. Radiol Technol 2015; 86 (05) 535M-558M , quiz 559–562
  • 5 Storm-Dickerson T, Sigalove NM. The breast surgeons' approach to mastectomy and prepectoral breast reconstruction. Gland Surg 2019; 8 (01) 27-35
  • 6 Sisco M. The burden of postmastectomy breast reconstruction. J Surg Oncol 2020; 122 (07) 1298-1299
  • 7 Li Y, Wang X, Thomsen JB. et al. Research trends and performances of breast reconstruction: a bibliometric analysis. Ann Transl Med 2020; 8 (22) 1529
  • 8 Serra M, Li AQ, Cataliotti L. et al; authors are grateful to. Aesthetic results following breast cancer surgery: a prospective study on 6515 cases from ten Italian Senonetwork breast centers. Eur J Surg Oncol 2020; 46 (10 Pt A): 1861-1866
  • 9 Casella D, Kaciulyte J, Lo Torto F. et al. “To Pre or Not to Pre”: introduction of a prepectoral breast reconstruction assessment score to help surgeons solving the decision-making dilemma. Retrospective results of a multicenter experience. Plast Reconstr Surg 2021; 147 (06) 1278-1286
  • 10 Bucher F, Vogt PM. The failed breast implant in postmastectomy reconstruction: a systematic literature review of complications of implant-based breast reconstruction. Ann Plast Surg 2022; 88 (06) 695-703
  • 11 Salibian AA, Frey JD, Karp NS. Strategies and considerations in selecting between subpectoral and prepectoral breast reconstruction. Gland Surg 2019; 8 (01) 11-18
  • 12 Petit JY, Rietjens M, Lohsiriwat V. et al. Update on breast reconstruction techniques and indications. World J Surg 2012; 36 (07) 1486-1497
  • 13 Spear SL, Murphy DK, Slicton A, Walker PS, Inamed Silicone Breast Implant US. Inamed Silicone Breast Implant U.S. Study Group. Inamed silicone breast implant core study results at 6 years. Plast Reconstr Surg 2007; 120 (7, suppl 1): 8S-16S
  • 14 Lee KT, Kim S, Jeon BJ. et al. Association of the implant surface texture used in reconstruction with breast cancer recurrence. JAMA Surg 2020; 155 (12) 1132-1140
  • 15 Marra A, Viale G, Pileri SA. et al. Breast implant-associated anaplastic large cell lymphoma: a comprehensive review. Cancer Treat Rev 2020; 84: 101963
  • 16 Collett DJ, Rakhorst H, Lennox P, Magnusson M, Cooter R, Deva AK. Current risk estimate of breast implant-associated anaplastic large cell lymphoma in textured breast implants. Plast Reconstr Surg 2019; 143 (3S A Review of Breast Implant-Associated Anaplastic Large Cell Lymphoma, 3S): 30S-40S
  • 17 El-Sabawi B, Sosin M, Carey JN, Nahabedian MY, Patel KM. Breast reconstruction and adjuvant therapy: a systematic review of surgical outcomes. J Surg Oncol 2015; 112 (05) 458-464
  • 18 Lisa AVE, Murolo M, Maione L. et al. Autologous fat grafting efficacy in treating postmastectomy pain syndrome: a prospective multicenter trial of two Senonetwork Italia breast centers. Breast J 2020; 26 (09) 1652-1658
  • 19 Homsy A, Rüegg E, Montandon D, Vlastos G, Modarressi A, Pittet B. Breast reconstruction: a century of controversies and progress. Ann Plast Surg 2018; 80 (04) 457-463
  • 20 Pedersen RN, Esen BÖ, Mellemkjær L. et al. The incidence of breast cancer recurrence 10-32 years after primary diagnosis. J Natl Cancer Inst 2022; 114 (03) 391-399
  • 21 El Saghir NS, Khalil LE, El Dick J. et al. Improved survival of young patients with breast cancer 40 years and younger at diagnosis. JCO Glob Oncol 2023; 9: e2200354
  • 22 Courtney D, Davey MG, Moloney BM. et al. Breast cancer recurrence: factors impacting occurrence and survival. Ir J Med Sci 2022; 191 (06) 2501-2510
  • 23 Vuong B, Darbinian J, Savitz A. et al. Breast cancer recurrence by subtype in a diverse, contemporary cohort of young women. J Am Coll Surg 2023; 237 (01) 13-23
  • 24 Pan H, Gray R, Braybrooke J. et al; EBCTCG. 20-year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years. N Engl J Med 2017; 377 (19) 1836-1846
  • 25 Ahmad A. Pathways to breast cancer recurrence. ISRN Oncol 2013; 2013: 290568
  • 26 Lee ZH, Chu CK, Asaad M. et al. Comparing donor site morbidity for autologous breast reconstruction: thigh vs. abdomen. Plast Reconstr Surg Glob Open 2022; 10 (03) e4215
  • 27 Svee A, Mani M, Sandquist K. et al. Survival and risk of breast cancer recurrence after breast reconstruction with deep inferior epigastric perforator flap. Br J Surg 2018; 105 (11) 1446-1453
  • 28 Klinger M, Losurdo A, Lisa AVE. et al. Safety of autologous fat grafting in breast cancer: a multicenter Italian study among 17 senonetwork breast units autologous fat grafting safety: a multicenter Italian retrospective study. Breast Cancer Res Treat 2022; 191 (02) 355-363
  • 29 Costanzo D, Klinger M, Lisa A, Maione L, Battistini A, Vinci V. The evolution of autologous breast reconstruction. Breast J 2020; 26 (11) 2223-2225
  • 30 Vinci V, Domenico C, Luca M. et al. The evolution of breast prostheses. Breast J 2020; 26 (09) 1801-1804
  • 31 Maxwell GP, Scheflan M, Spear S, Nava MB, Hedén P. Benefits and limitations of macrotextured breast implants and consensus recommendations for optimizing their effectiveness. Aesthet Surg J 2014; 34 (06) 876-881
  • 32 Wixtrom RN, Garadi V, Leopold J, Canady JW. Device-specific findings of imprinted-texture breast implants: characteristics, risks, and benefits. Aesthet Surg J 2020; 40 (02) 167-173
  • 33 Gfrerer L, Mattos D, Mastroianni M. et al. Assessment of patient factors, surgeons, and surgeon teams in immediate implant-based breast reconstruction outcomes. Plast Reconstr Surg 2015; 135 (02) 245e-252e
  • 34 Eriksen C, Frisell J, Wickman M, Lidbrink E, Krawiec K, Sandelin K. Immediate reconstruction with implants in women with invasive breast cancer does not affect oncological safety in a matched cohort study. Breast Cancer Res Treat 2011; 127 (02) 439-446
  • 35 McCarthy CM, Pusic AL, Sclafani L. et al. Breast cancer recurrence following prosthetic, postmastectomy reconstruction: incidence, detection, and treatment. Plast Reconstr Surg 2008; 121 (02) 381-388
  • 36 Jayasingam SD, Citartan M, Thang TH, Mat Zin AA, Ang KC, Ch'ng ES. Evaluating the polarization of tumor-associated macrophages into M1 and M2 phenotypes in human cancer tissue: technicalities and challenges in routine clinical practice. Front Oncol 2020; 9: 1512
  • 37 Orciani M, Caffarini M, Torresetti M. et al. Breast implant texturization does not affect the crosstalk between MSC and ALCL cells. Inflammation 2019; 42 (02) 721-730
  • 38 Myint AA, Lee W, Mun S, Ahn CH, Lee S, Yoon J. Influence of membrane surface properties on the behavior of initial bacterial adhesion and biofilm development onto nanofiltration membranes. Biofouling 2010; 26 (03) 313-321
  • 39 James GA, Boegli L, Hancock J, Bowersock L, Parker A, Kinney BM. Bacterial adhesion and biofilm formation on textured breast implant shell materials. Aesthetic Plast Surg 2019; 43 (02) 490-497
  • 40 Danino MA, Efanov JI, Dimitropoulos G. et al. Capsular biofilm formation at the interface of textured expanders and human acellular dermal matrix: a comparative scanning electron microscopy study. Plast Reconstr Surg 2018; 141 (04) 919-928
  • 41 Hu H, Jacombs A, Vickery K, Merten SL, Pennington DG, Deva AK. Chronic biofilm infection in breast implants is associated with an increased T-cell lymphocytic infiltrate: implications for breast implant-associated lymphoma. Plast Reconstr Surg 2015; 135 (02) 319-329
  • 42 Silva MM, Modolin M, Faintuch J. et al. Systemic inflammatory reaction after silicone breast implant. Aesthetic Plast Surg 2011; 35 (05) 789-794
  • 43 Cole SW. Chronic inflammation and breast cancer recurrence. J Clin Oncol 2009; 27 (21) 3418-3419