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Review: Implant-Based Breast Reconstruction After Mastectomy for Breast Cancer: A Meta-analysis of Randomized Controlled Trials and Prospective Studies Comparing Use of Acellular Dermal Matrix (ADM) Versus Without ADM.
Ng, Trina Priscilla; Loo, Brandon Yong Kiat; Yong, Nicole; Chia, Clement Luck Khng; Lohsiriwat, Visnu.
Afiliação
  • Ng TP; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
  • Loo BYK; Breast Surgery Service, Department of Surgery, Khoo Teck Puat Hospital, Singapore, Singapore.
  • Yong N; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
  • Chia CLK; Breast Surgery Service, Department of Surgery, Khoo Teck Puat Hospital, Singapore, Singapore.
  • Lohsiriwat V; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Ann Surg Oncol ; 31(5): 3366-3376, 2024 May.
Article em En | MEDLINE | ID: mdl-38285304
ABSTRACT

BACKGROUND:

Breast cancer is the world's most prevalent cancer, and many breast cancer patients undergo mastectomy as the choice of treatment, often with post-mastectomy breast reconstruction. Acellular dermal matrix (ADM) use has become a method to improve outcomes of reconstruction for these patients. We aimed to compare postoperative complications and patient-reported outcomes, which are still poorly characterized, between groups utilizing acellular dermal matrix during reconstruction and those without. MATERIALS AND

METHODS:

We searched electronic databases from inception to 16 June 2022 for randomized controlled trials and prospective cohort studies comparing the outcomes of patients who have and have not received acellular dermal matrix in implant-based breast reconstruction. The results were quantitatively combined and analyzed using random-effects models.

RESULTS:

A total of nine studies were included, representing 3161 breasts. There was no significant difference in postoperative outcomes, such as seroma formation (p = 0.51), hematomas (p = 0.20), infections (p = 0.21), wound dehiscence (p = 0.09), reoperations (p = 0.70), implant loss (p = 0.27), or skin necrosis (p = 0.21). Only two of the studies included evaluated patient-reported outcomes between the use and non-use of ADM in implant-based breast reconstruction using BREAST-Q questionnaire, as well as self-reported pain. There was no reported significant difference in BREAST-Q or pain scores.

CONCLUSIONS:

This meta-analysis shows comparable short- and long-term outcomes between ADM and non-ADM breast reconstruction, suggesting that the use of ADM may not be necessary in all cases given their additional cost. However, there is a paucity of data for patient-reported outcomes, and further research is required to determine whether ADM use affects patient-reported outcomes.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Mamoplastia / Implantes de Mama / Implante Mamário / Derme Acelular Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Systematic_reviews Limite: Female / Humans Idioma: En Revista: Ann Surg Oncol Assunto da revista: NEOPLASIAS Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Singapura

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Mamoplastia / Implantes de Mama / Implante Mamário / Derme Acelular Tipo de estudo: Clinical_trials / Observational_studies / Prognostic_studies / Systematic_reviews Limite: Female / Humans Idioma: En Revista: Ann Surg Oncol Assunto da revista: NEOPLASIAS Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Singapura