Abstract
Evaluation of early experience with implant based breast reconstruction for early breast cancer in ptotic breasts with titanium coated polypropylene mesh and lower pole dermal sling. A pilot prospective ongoing study where patients having immediate implant based reconstruction with non biological mesh and lower pole dermal sling are evaluated simultaneously. Patient, surgical, and tumour related factors are presented as well as the cosmetic outcome in five patients, two of whom underwent bilateral procedure for bilateral breast cancer and one who underwent simultaneous symmetrisation with reduction mammoplasty on the contralateral side. All five patients had good cosmetic outcome with minor complications. There was no delay in adjuvant treatment due to complications. All were satisfied with their results and would recommend this treatment to others. Using a non biological mesh as well as a lower pole dermal sling, which covers the suture line and offers an extra layer of protection to the mesh, reduces the complication rate especially in patients who may be at higher risk of wound related problems such as those with increased body mass index. This procedure is also cost effective (non biological meshes are only 1/5th of the cost compared to biological meshes) and provides equivalent cosmetic outcomes in a select group of patients.
Highlights
The incidence of breast cancer continues to increase throughout the world
Non biological meshes, good cosmetic outcome can be achieved at the present time [2]
The cost of biological meshes can be a prohibitive factor in offering this to all patients requiring implant based reconstruction [3]
Summary
The incidence of breast cancer continues to increase throughout the world. In 2011, there were 50,285 new cases of breast cancer in the UK. Patients with early breast cancer who need to undergo mastectomy are offered immediate as well as delayed reconstruction routinely in the UK. 30 % of patients (national mastectomy breast reconstruction (NMBRA) audit) in the immediate reconstruction setting opted to have implant based reconstruction after weighing up all the options available to them. With the availability of various biological and non biological meshes, good cosmetic outcome can be achieved at the present time [2]. The cost of biological meshes can be a prohibitive factor in offering this to all patients requiring implant based reconstruction [3]. Non biological meshes as an alternative are cost effective and can be substituted for biological meshes [4]
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