Experience with prepectoral implant-based reconstruction for breast cancer
DOI: 10.32364/2587-6821-2023-7-6-5
O.S. Khodorovich, V.A. Solodkiy, A.A. Kalinina-Masri, A.A. Tashchyan, T.V. Sherstneva, V.O. Kleshneva, L.B. Kanakhina
Russian Scientific Center for X-ray Radiology, Moscow, Russian Federation
Prepectoral implant-based simultaneous breast reconstruction is now employed more often and demonstrates good long-term outcomes with good quality of life after breast cancer (BC) surgery. We share our experience with reconstructive surgeries performed in 308 women diagnosed with BC by prepectoral implant placement. Polyurethane-coated implants were used in 50%, textured implants in 42.2%, and tissue expanders later replaced by textured implants in 7.8%. Prepectoral implant-based breast reconstruction was most commonly (74.5%) performed in women with early disease (stage 0-IIa). 150 women (48.7%) received chemotherapy after surgery. 40 women (12.9%) received radiotherapy (60% were women with polyurethane implants and 40% were women with textured implants). Radiotherapy was performed in 12 women (3.8%) with tissue expanders. In some women, complications occurred in the setting of ongoing radiotherapy and/or chemotherapy, which illustrates the need for careful patient selection for this surgical intervention. Improving surgical techniques and methods for preventing complications allows more active and effective introduction of prepectoral implant-based breast reconstruction.
Keywords: prepectoral reconstruction, implant-based breast reconstruction, breast cancer, tissue expander, textured implant, polyurethane implant.
For citation: Khodorovich O.S., Solodkiy V.A., Kalinina-Masri A.A., Tashchyan A.A., Sherstneva T.V., Kleshneva V.O., Kanakhina L.B. Experience with prepectoral implant-based reconstruction for breast cancer. Russian Medical Inquiry. 2023;7(6):366–371 (in Russ.). DOI: 10.32364/2587-6821-2023-7-6-5.
About the authors:
Vladimir A. Solodkiy — Academician of the RAS, Professor, Director of the Russian Scientific Center for X-ray Radiology; 86, Profsoyuznaya str., Moscow, 117997, Russian Federation; ORCID iD 0000-0002-1641-6452.
Olga S. Khodorovich — Dr. Sc. (Med.), Head of the Clinics of the Complex Diagnostic and Treatment Methods for Breast Disorders, Russian Scientific Center for X-ray Radiology; 86, Profsoyuznaya str., Moscow, 117997, Russian Federation; ORCID iD 0000-0002-6014-4597.
Alena A. Kalinina-Masri — C. Sc. (Med.), surgeon of the Clinics of the Complex Diagnostic and Treatment Methods for Breast Disorders, Russian Scientific Center for X-ray Radiology; 86, Profsoyuznaya str., Moscow, 117997, Russian Federation; ORCID iD 0000-0002-8265-1848.
Agvan A. Tashchyan — C. Sc. (Med.), surgeon of the Department of Surgical Treatment and Anticancer Drug Therapy for Breast Cancer with Surgical Beds, Russian Scientific Center for X-ray Radiology; 86, Profsoyuznaya str., Moscow, 117997, Russian Federation.
Tat'yana V. Sherstneva — C. Sc. (Med.), Head of the Department of the Complex Diagnostics for Breast Disorders, Russian Scientific Center for X-ray Radiology; 86, Profsoyuznaya str., Moscow, 117997, Russian Federation; ORCID iD 0000-0002-3261-0984.
Viktoriya O. Kleshneva — junior researcher of the Laboratory of X-ray Radiology of the Scientific Research Division of Complex Diagnostics and Radiotherapy, Russian Scientific Center for X-ray Radiology; 86, Profsoyuznaya str., Moscow, 117997, Russian Federation; ORCID iD 0000-0002-0802-2437.
Liya B. Kanakhina — radiologist of the Laboratory of X-ray Radiology of the Scientific Research Division of Complex Diagnostics and Radiotherapy, Russian Scientific Center for X-ray Radiology; 86, Profsoyuznaya str., Moscow, 117997, Russian Federation; ORCID iD 0000-0003-0260-1478.
Contact information: Alena A. Kalinina-Masri, e-mail: kalinina-masri@yandex.ru.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 26.05.2023.
Revised 21.06.2023.
Accepted 14.07.2023.
2. Каприн А.Д., Старинский В.В., Петрова Г.В. Злокачественные новообразования в России в 2018 году (заболеваемость и смертность). М.: МНИОИ им. П.А. Герцена — филиал ФГБУ «НМИЦ радиологии» Минздрава России, 2019. [Kaprin A.D., Starinsky V.V., Petrova G.V. Malignant neoplasms in Russia in 2018 (morbidity and mortality). M.: P.A. Herzen Moscow State Medical Research Institute — Branch of the Federal State Budgetary Institution "NMIC of Radiology" of the Ministry of Health of Russia, 2019 (in Russ.)].
3. Sung-Eun Kim. Prepectoral breast reconstruction. Yeungnam Univ J Med. 2019;36(3):201–207. DOI: 10.12701/yujm.2019.00283.
4. Ciancio F., Parisi D., Portincasa A., Innocenti A. Innovative Management of Implant Exposure in ADM/Implant-Based Breast Reconstruction with Negative Pressure Wound Therapy. Aesthetic Plast Surg. 2017;41:1237–1238 DOI: 10.1007/s00266-017-0850-y.
5. Alderton G.K. Breast cancer: breast cancer classification. Nat Rev Cancer. 2014;24(3):155. DOI: 10.1038/nrc3697.
6. Henry L.R., Morris L.L., Downs R., Schwarz R.E. The impact of immediate breast reconstruction after mastectomy on time to first adjuvant 130 treatment in women with breast cancer in a community setting. Am J Surg. 2017;213(3):534–538. DOI: 10.1016/j.amjsurg.2016.11.004.
7. Солодкий В.А., Ходорович О.С., Саркисян К.Д., Калинина-Масри А.А. Симметризирующие вмешательства при органосохранных и реконструктивных операциях у больных раком молочной железы. Вестник РНЦРР. 2019;19:52–63. [Solodkiy V.A., Khodorovich O.S., Sarkisyan K.D., Kalinina-Masri A.A. Symmetrical interventions in organ-preserving and reconstructive operations in patients with breast cancer. Vestnik RNСRR. 2019;19:52–63 (in Russ.)].
8. Hong H.K., Kim Y.H., Lee J. et al. Prepectoral breast reconstruction with complete anterior implant coverage using a single, large, square-shaped acellular dermal matrix. BMC Surgery. 2022;22(1):234. DOI: 10.1186/s12893-022-01683-z.
9. Ходорович О.С., Солодкий В.А., Калинина-Масри А.А. и др. Рак молочной железы у пациенток после аугментации имплантами. Вопросы онкологии. 2021;67(4):518–524. DOI: 10.17116/plast.hirurgia202201132. [Khodorovich O.S., Solodkiy V.A., Kalinina-Masri A.A. et al. Breast cancer in patients after implant augmentation. Voprosy onkologii. 2021;67(4):518–524 (in Russ.)]. DOI: 10.17116/plast.hirurgia202201132.
10. Зикиряходжаев А.Д., Ермощенкова М.В., Фетисова Е.Ю. и др. Опыт применения силиконовых имплантатов Mentor при реконструкции молочной железы по поводу рака в 2015 г. Поволжский онкологический вестник. 2016;(1):37–41. [Zikiryakhodzhaev A.D., Ermoshchenkova M.V., Fetisova E.Yu. et al. Experience of using Mentor silicone implants in breast reconstruction glands for cancer in 2015. Povolzhskij onkologicheskij vestnik. 2016;(1):37–41 (in Russ.)].
11. Власова М.Ю., Зикиряходжаев А.Д., Решетов И.В. и др. Препекторальная установка полиуретанового имплантата после подкожной мастэктомии у больных раком молочной железы. Исследования и практика в медицине. 2020;7(3):63–73. DOI: 10.17709/2409-2231-2020-7-3-6. [Vlasova M.Yu., Zikiryakhodzhaev A.D., Reshetov I.V. et al. Prepectoral reconstruction with polyurethane-coated implant after skin-sparing mastectomy in patients with breast cancer. Research and Practical Medicine Journal (Issled. prakt. med.). 2020;7(3):63–73 (in Russ.)]. DOI: 10.17709/2409-2231-2020-7-3-6.
12. Ostapenko E., Nixdorf L., Devyatko Ye. et al. Prepectoral Versus Subpectoral Implant-Based Breast Reconstruction: A Systemic Review and Meta-analysis. Ann Surg Oncol. 2023;30(1):126–136. DOI: 10.1245/s10434-022-12567-0.
13. Kappos E.A., Schulz A., Regan M.M. et al. Prepectoral versus subpectoral implant-based breast reconstruction after skin-sparing mastectomy or nipple-sparing mastectomy (OPBC-02/ PREPEC): a pragmatic, multicentre, randomised, superiority trial. BMJ Open. 2021;11(9):e045239. DOI: 10.1136/bmjopen-2020-045239.
14. Ходорович О.С., Солодкий В.А., Саркисян К.Д. и др. Препекторальная установка имплантата при реконструктивных операциях у больных с диагнозом «рак молочной железы». Пластическая хирургия и эстетическая медицина. 2022;(1):32–40. DOI: 10.17116/ plast.hirurgia202201132. [Khodorovich O.S., Solodkiy V.A., Sarkisyan K.D. et al. Prepectoral implant-based breast reconstruction in patients with breast cancer. Plastic Surgery and Aesthetic Medicine. 2022;(1):32–40 (in Russ.)]. DOI: 10.17116/plast.hirurgia202201132.
15. Vidya R., Masià J., Cawthorn S. et al. Evaluation of the effectiveness of the prepectoral breast reconstruction with Braxon dermal matrix: first multicenter European report on 100 cases. Breast J. 2017;23(6):670–676. DOI: 10.1111/tbj.12810.
16. Тащян А.А., Ходорович О.С., Астатурян К.С., Канахина Л. Способ одномоментной реконструкции молочной железы при хирургическом лечении рака молочной железы. Патент № 2020107165/14(011384). Опубликован 24.12.2019. [Tashyan A.A., Khodorovich O.S., Astaturyan K.S., Kanakhina L. Method of simultaneous breast reconstruction in the surgical treatment of breast cancer. Patent No. 2020107165/14(011384). Published on 24.12.2019 (in Russ.)].
17. Байчоров Э.А., Зикиряходжаев А.Д., Исмагилов А.Х., Ванесян А.С. Сравнительный анализ качества жизни, связанного со здоровьем пациентов с раком молочной железы, после одномоментной препекторальной реконструкции. Пластическая хирургия и эстетическая медицина. 2022;(2):25–32. DOI: 10.17116/plast. hirurgia202202125. [Bajchorov E.A., Zikiryakhodzhaev A.D., Ismagilov A.H., Vanesyan A.S. Comparative analysis of health-related quality of life in patients with breast cancer after single-stage prepectoral reconstruction. Plastic surgery and aesthetic medicine. 2022;(2):25–32 (in Russ.)]. DOI: 10.17116/plast.hirurgia202202125.
This work is licensed under a Creative Commons «Attribution» 4.0 License.
Распечатать