We evaluate postoperative complications, aesthetic results and satisfaction outcomes in patients with breast cancer after intervening with a skin-sparing or nipple-sparing mastectomy with an immediate prosthetic reconstruction with or without a biological mesh. Patients with multifocal breast cancer, ductal carcinoma in situ with an indication for a mastectomy and cT2 tumors with no response to primary systemic treatment were included, whereas patients aged >75 years, with inflammatory carcinoma, and severe circulatory disorders were excluded. Patients in the control group were reconstructed using a prosthesis, whereas the study group included patients reconstructed using a prosthesis and biological acellular porcine dermal mesh (Strattice™). In both groups, the result was assessed using the BREAST-Q instrument. A total of 51 patients (62 intervened breasts) were included in the study group and 38 patients (41 intervened breasts) in the control group. Implant loss and removal occurred in three patients in the study group (5.9%) and nine patients in the control group (24.3%;p= 0.030). Infections appeared in three patients in the study group (4.8%) and three patients in the control group (7.3%;p= 1.00). Skin necrosis appeared in 5 patients in the study group (12.2%) and 11 patients in the control group (21.6%;p= 0.367). Seroma appeared in five patients in the study group (12.2%) and five patients in the control group (8.1%;p= 0.514). The BREAST-Q questionnaire is a comparison between both groups regarding “satisfaction with breasts after surgery” (p= 0.026), “sexual well-being after intervention” (p= 0.010) and “satisfaction with the information received” (p= 0.049). We have noted a statistically significant decrease in implant loss in women receiving an implant with a biological mesh. A higher satisfaction was observed in patients reconstructed using Strattice™, with statistically significant differences in three items.
本研究评估了乳腺癌患者在接受保留皮肤或保留乳头的乳房切除术后，联合即刻假体重建（无论是否使用生物补片）的术后并发症、美学效果及满意度结果。研究对象包括多灶性乳腺癌、需行乳房切除术的导管原位癌以及对新辅助系统治疗无反应的cT2期肿瘤患者，而年龄大于75岁、患有炎性乳腺癌及严重循环系统疾病的患者被排除在外。对照组患者仅采用假体进行重建，而研究组患者则采用假体联合生物脱细胞猪真皮补片（Strattice™）进行重建。两组患者均使用BREAST-Q量表评估结果。研究组共纳入51例患者（62侧乳房），对照组纳入38例患者（41侧乳房）。研究组中有3例患者（5.9%）发生假体丢失或取出，而对照组有9例（24.3%；p=0.030）。研究组有3例患者（4.8%）发生感染，对照组有3例（7.3%；p=1.00）。研究组5例患者（12.2%）出现皮肤坏死，对照组为11例（21.6%；p=0.367）。研究组5例患者（12.2%）出现血清肿，对照组为5例（8.1%；p=0.514）。BREAST-Q问卷显示两组在“术后乳房满意度”（p=0.026）、“干预后性健康”（p=0.010）及“对接收信息的满意度”（p=0.049）方面存在显著差异。研究发现，使用生物补片联合假体重建的患者假体丢失率显著降低。采用Strattice™重建的患者满意度更高，其中三项指标具有统计学显著差异。
肿瘤(癌症)患者之家