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Multicenter Study

The largest multicentre data collection on prepectoral breast reconstruction: The iBAG study

Jaume Masià et al. J Surg Oncol. 2020 Oct.

Abstract

Background and objectives: In the last years, prepectoral breast reconstruction has increased its popularity, becoming a standard reconstructive technique by preserving pectoralis major anatomy and functionality. Nevertheless, the lack of solid and extensive data negatively impacts on surgeons' correct information about postoperative complication rates and proper patient selection. This study aims to collect the largest evidence on this procedure.

Methods: A multicentre retrospective audit, promoted by the Barcelona Hospital, collected the experience of 30 centers on prepectoral breast reconstruction with Braxon ADM. The study had the scientific support of INPECS and IIB societies which provided the online database Clinapsis.

Results: A total of 1450 procedures were retrospectively collected in a 6-year period. Mean age 52.4 years, BMI 23.9, follow-up 22.7 months. Reconstruction was carried out after a tumor in 77.1% of the cases, 20.1% had prophylactic surgery, 2.8% had revisions. Diabetes, smoke, and immunosuppression had an influence on complications occurrence, as well as implant weight. Capsular contracture was associated with postoperative radiotherapy, but the overall rate was low (2.1%). Complications led to implant loss in 6.5% of the cases.

Conclusions: The international Braxon Audit Group multicentre data collection represents a milestone in the field of breast reconstruction, extensively improving the knowledge on this procedure.

Keywords: acellular dermal matrix; braxon; breast reconstruction; prepectoral; radiotherapy.

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Conflict of interest statement

The authors declare that there are no conflict of interests.

Figures

Figure 1
Figure 1
Standardized wrapping technique of Braxon ADM around the breast implant. The patented shaped allows a complete cover acting as an internal “implant bag” which distributes the weight of the silicone prosthesis around all the breast pocket and hides it from the direct contact with the organism. ADM acellular dermis matrix [Color figure can be viewed at wileyonlinelibrary.com]
Figure 2
Figure 2
A‐C, Preoperative pictures in lateral and frontal view, slight asymmetry of the right breast due to a previous clinical investigation; D‐F outcomes at 21 months of unilateral right nipple‐sparing mastectomy and prepectoral breast reconstruction with Braxon; G‐I, preoperative lateral and frontal views of an IDC left case; J‐L, outcome of left immediate prepectoral reconstruction after nipple‐sparing mastectomy and right breast augmentation, 7 months postop. IDC, invasive ductal carcinoma [Color figure can be viewed at wileyonlinelibrary.com]
Figure 3
Figure 3
A‐C, Preoperative lateral and frontal views; D‐F, 12 months postop outcomes of left immediate prepectoral breast reconstruction; G‐I, frontal and lateral views of right IDC case; J‐L, 7 months from the bilateral prepectoral reconstruction after nipple‐sparing mastectomies [Color figure can be viewed at wileyonlinelibrary.com]
Figure 4
Figure 4
A‐C, Preoperative lateral and frontal pictures of a right DCIS case; D‐F, esthetic result after 6 months of right immediate prepectoral reconstruction; G‐I, preoperative lateral and frontal pictures of a failure of previous left breast reconstruction; J‐l, outcomes of left delayed prepectoral breast reconstruction, 24 months postoperative. DCIS, ductal carcinoma in situ [Color figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

References

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