The suitability of absorbable mesh insertion for oncoplastic breast surgery in patients with breast cancer scheduled to be irradiated

The objective of this study was to investigate the influence of radiotherapy on the cosmetic outcome after immediate breast reconstruction using an absorbable mesh in breast cancer. From July 2008 to July 2009, 35 breast cancer patients who received immediate breast reconstruction with absorbable mesh insertion at the time of breast conserving surgery followed by radiotherapy were retrospectively studied. In 91% of cases there was an excellent or good cosmetic outcome before the initiation of radiotherapy, and in 8.6% the outcome was fair at this point. However, 6 months after surgery and irradiation, the rate of excellent to good cosmetic outcomes had decreased to 60% and fair outcomes had increased to 25.7%. Contrary to the decreased rate of good cosmetic outcomes from 65.7% to 42.9% at 1 year after operation, the rate of fair to poor outcomes considerably increased from 8.6% to 57.1%. The significant factors affecting cosmetic outcomes were pathology, specimen volume, and the estimated percentage of breast volume excised (EPBVE). Chemotherapy affected the cosmetic outcome at borderline significance level. Age, breast volume tumor site, insertion of drain, radiation dose, and time elapsed between surgery and radiotherapy were not significantly associated with the cosmetic outcome. Applying an absorbable mesh for the immediate reconstruction of the breast should be carefully considered in patients with an EPBVE of over 30% who are scheduled to be irradiated.