Reconstrucción mamaria inmediata mediante implante prepectoral de poliuretano. Resultados preliminares del estudio prospectivo PreQ-20 / Immediate breast reconstruction by prepectoral polyurethane implant: Preliminary results of the prospective study PreQ-20

Introducción: Durante los últimos años las técnicas de mastectomía y reconstrucción han evolucionado hacia procedimientos menos agresivos, mejorando la satisfacción y calidad de vida de la mujer. Por ello, la mastectomía se ha convertido en una opción válida tanto para mujeres con cáncer de mama como en mujeres de alto riesgo. El objetivo de este estudio es analizar la seguridad de la mastectomía y reconstrucción inmediata prepectoral con implante de poliuretano en mujeres con cáncer de mama y reducción de riesgo. Métodos: Estudio prospectivo observacional para evaluar la factibilidad y seguridad de la reconstrucción inmediata mediante implante prepectoral de poliuretano. Se incluyeron todas las mujeres (con cáncer de mama o alto riesgo para cáncer de mama) intervenidas mediante una mastectomía preservadora de piel o piel y pezón con reconstrucción inmediata con implante de poliuretano prepectoral. Se excluyeron las mujeres con sarcomas de mama, progresión de la enfermedad durante el tratamiento sistémico primario, reconstrucción diferida, autóloga o retropectoral y aquellas pacientes que no desearon participar en el estudio. Los procedimientos quirúrgicos fueron realizados tanto por cirujanos senior como junior. Todas las pacientes recibieron los tratamientos complementarios correspondientes. Se analizaron todos los eventos adversos acontecidos durante el seguimiento y los factores de riesgo para desarrollarlos. Resultados: Se realizaron 159 reconstrucciones en 102 mujeres, el 80,4% por un carcinoma mamario. Catorce pacientes desarrollaron complicaciones, siendo el seroma y la dehiscencia de la herida las más frecuentes. Ocho mujeres precisaron una reintervención (5%), 7 de ellas por exposición del implante. Cuatro reconstrucciones (2,5%) culminaron con pérdida del implante. Tres pacientes presentaron progresión de su proceso oncológico: una recaída local en el colgajo de la mastectomía, una progresión axilar y una progresión sistémica. (AU)

Introduction: In recent years, mastectomy and reconstruction techniques have evolved towards less aggressive procedures, improving the satisfaction and quality of life of women. For this reason, mastectomy has become a valid option for both women with breast cancer and high-risk women. The objective of this study is to analyze the safety of mastectomy and immediate prepectoral reconstruction with polyurethane implant in women with breast cancer and risk reduction. Method: Observational prospective study to evaluate the feasibility and safety of immediate reconstruction using prepectoral polyurethane implant. All women (with breast cancer or high risk for breast cancer) who underwent skin-sparing or skin-and-nipple-sparing mastectomy with immediate reconstruction with a prepectoral polyurethane implant were included. Women with breast sarcomas, disease progression during primary systemic therapy, delayed, autologous or retropectoral reconstruction, and those who did not wish to participate in the study were excluded. Surgical procedures were performed by both senior and junior surgeons. All patients received the corresponding complementary treatments. All adverse events that occurred during follow-up and the risk factors for developing them were analyzed. Results: 159 reconstructions were performed in 102 women, 80.4% due to breast carcinoma. Fourteen patients developed complications, the most frequent being seroma and wound dehiscence. Eight women required a reoperation (5.0%), seven of them due to implant exposure. Four reconstructions (2.5%) resulted in loss of the implant. Three patients progressed from their oncological process: a local relapse in the mastectomy flap, an axillary progression and a systemic progression. (AU)

Immediate breast reconstruction by prepectoral polyurethane implant: Preliminary results of the prospective study PreQ-20.

INTRODUCTION: In recent years, mastectomy and reconstruction techniques have evolved towards less aggressive procedures, improving the satisfaction and quality of life of women. For this reason, mastectomy has become a valid option for both women with breast cancer and high-risk women. The objective of this study is to analyze the safety of mastectomy and immediate prepectoral reconstruction with polyurethane implant in women with breast cancer and risk reduction. METHOD: Observational prospective study to evaluate the feasibility and safety of immediate reconstruction using prepectoral polyurethane implant. All women (with breast cancer or high risk for breast cancer) who underwent skin-sparing or skin-and-nipple-sparing mastectomy with immediate reconstruction with a prepectoral polyurethane implant were included. Women with breast sarcomas, disease progression during primary systemic therapy (PST), delayed, autologous or retropectoral reconstruction, and those who did not wish to participate in the study were excluded. Surgical procedures were performed by both senior and junior surgeons. All patients received the corresponding complementary treatments. All adverse events that occurred during follow-up and the risk factors for developing them were analyzed. RESULTS: 159 reconstructions were performed in 102 women, 80.4% due to breast carcinoma. Fourteen patients developed complications, the most frequent being seroma and wound dehiscence. Eight women required a reoperation (5.0%), seven of them due to implant exposure. Four reconstructions (2.5%) resulted in loss of the implant. Three patients progressed from their oncological process: a local relapse in the mastectomy flap, an axillary progression and a systemic progression. CONCLUSIONS: Prepectoral reconstruction with a polyurethane implant is a procedure with a low incidence of postoperative complications (8.8%) and implant loss (2.5%). Its use is safe with perioperative cancer treatments (neoadjuvant chemotherapy and radiotherapy).