69 (PB-069) Poster - Selective pectoralis major muscle denervation in retro-pectoral implant based breast reconstruction reduces capsular contracture rate. Long-term single institution prospective case-control study

Abstract

Background: Implant-based breast reconstruction (IBBR) continues to be the most used technique for breast reconstruction worldwide. Until few years ago the gold standard was to place the device in a retro-pectoral position but, recently, pre-pectoral breast reconstruction has gained a general success, due to better aesthetic outcomes and lower capsular contracture (CC) rates. Unfortunately, not all patients are good candidates for pre-pectoral IBBR and, in these cases, retro-pectoral technique remains a right choice. CC is a well-recognized complication following IBBR and represents a cause of discomfort, pain, poor cosmetic result and sometimes requires revision surgery especially in the retro-pectoral approach. The Pectoralis Major Muscle (PMM) selective denervation, in the retro-pectoral approach, is an innovative technical modification to avoid some pitfalls of the retro-pec IBBR. Material and methods: We prospectively selected a group of denervated retro-pec IBBR patients and compared them with not denervated patients. Group 1 included cases with selective PMM denervation and Group 2 patients without denervation performed in the same time span. In a previous study we analyzed the subjective opinion on the reconstruction outcomes by means of the BREAST-Q postoperative questionnaire, while, recently, we compared the same groups, with a minimum 24 month follow-up, from an objective perspective, evaluating CC rates by Baker scale, through outpatient clinic visits, performed by three independent breast cancer professionals. Results: The overall median follow-up was 3.35 years and CC rate was significantly lower in Group 1, even adjusting for propensity score. Conclusions: PMM selective denervation has gained a statistical appreciation by women and seems to significantly reduce CC rate from an objective evaluation in the setting of retro-pectoral IBBR in our single Institution series. No conflict of interest.