Abstract
Background: Acellular dermal matrix (ADM) in implant-based breast reconstruction can show various ultrasound (US) findings. However, there are limited reports on the US features of the ADM. The aims of this study were to evaluate US findings of the ADM in implant-based breast reconstruction and correlate them with histopathological findings. Methods: Between January 2015 and August 2020, 250 women who underwent implant-based breast reconstruction with ADM and a breast US examination at 6 months to 1 year after reconstruction were retrospectively analyzed. Abnormal US findings were classified as type 1 (focal thickening with decreased echogenicity), 2 (diffusely hyperechoic), or 3 (bright echogenic spots). ADM biopsy was performed in 33 patients who underwent second stage or revisional surgeries. Results: In total, 176 consecutive women with 207 US findings were analyzed. The US findings were normal in 52.2% of the women. The percentages of type 1, 2, and 3 patients were 13.5%, 11.1%, and 23. 2%, respectively. These patients had microscopic findings that showed patchy areas with chronic inflammatory infiltrates, dense collagen bundles without degenerative or inflammatory changes, and empty spaces or degenerated foci unaccompanied by inflammation. Conclusion: Knowing the various ADM presentations on US can help avoid unnecessary invasive procedures.
Highlights
Published: 17 February 2022Breast cancer is the most diagnosed cancer in women worldwide and the leading cause of cancer-related deaths [1]
Breast-conserving surgery with adjuvant radiation therapy is the standard treatment for small breast cancer, but wide resection margins are necessary for oncologic safety, potentially resulting in a deformed breast and asymmetric size compared to the contralateral breast
Mastectomy followed by breast reconstruction can achieve oncological safety, better cosmetic outcomes, and improve patients’ psychological health postoperatively
Summary
Published: 17 February 2022Breast cancer is the most diagnosed cancer in women worldwide and the leading cause of cancer-related deaths [1]. With early detection and improved treatment, breast cancer-related mortality rates have been decreasing since 1990 [1,2]. Mastectomy followed by breast reconstruction can achieve oncological safety, better cosmetic outcomes, and improve patients’ psychological health postoperatively. There are two main techniques for breast reconstruction: using patients’ own tissues, including deep inferior epigastric perforator flap, latissimus dorsi flap, and other autologous flaps, and with implant-based reconstruction. The latter is the most common option following mastectomy [3]. A major paradigm shift occurred after introducing the acellular dermal matrix (ADM) into breast reconstruction [4,5].
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