000			04222nam a22005417a 4500
008			211101s20212021 xxu||||| |||| 00| 0 eng d
022			_a1068-9265
040			_aOvid MEDLINE(R)
099			_a34386913
245			_aA Critical Appraisal of Late Complications of Prepectoral versus Subpectoral Breast Reconstruction Following Nipple-Sparing Mastectomy.
251			_aAnnals of Surgical Oncology. 28(13):9150-9158, 2021 Dec.
252			_aAnn Surg Oncol. 28(13):9150-9158, 2021 Dec.
252			_zAnn Surg Oncol. 2021 Aug 12
253			_aAnnals of surgical oncology
260			_c2021
260			_fFY2022
265			_saheadofprint
265			_sppublish
266			_d2021-11-01
268			_aAnnals of Surgical Oncology. 2021 Aug 12
269			_fFY2022
520			_aBACKGROUND: Nipple-sparing mastectomy (NSM) offers improved aesthetics without compromising oncologic safety. Subpectoral breast reconstruction has long been standard practice, although prepectoral reconstruction has recently resurged in popularity. Due to this recent paradigm shift, studies comparing long-term outcomes by reconstructive plane are lacking.
520			_aCONCLUSIONS: This single-institution experience compares late complications of prepectoral and subpectoral implant-based reconstruction following NSM. Prepectoral reconstruction can be safely performed with improved understanding of mastectomy planes, readily affords DTI reconstruction, and reduces animation deformity at the expense of rippling. Copyright (c) 2021. Society of Surgical Oncology.
520			_aMETHODS: A retrospective review was conducted on consecutive NSMs with implant-based reconstruction in either the prepectoral or subpectoral plane from 2014 to 2018. Patient demographics, implant specifications, and operative details were collected to evaluate primary outcomes of prosthetic failure and unplanned reoperations by reconstructive plane. Secondary outcomes included animation deformity, capsular contracture, rippling, plane change, and minor revisions, including fat grafting. Bivariate and multivariate analyses were performed to assess outcomes.
520			_aRESULTS: Overall, 405 NSMs were performed on 228 women (subpectoral = 202, prepectoral = 203), with a mean follow-up of 2.1 years (standard deviation 1.1). During the study period (2014-2018), a shift from subpectoral to predominantly prepectoral mastectomies occurred in 2017. Prepectoral reconstructions were more often direct-to-implant (DTI) compared with subpectoral (73.9% vs. 33.2%, p < 0.001). Prepectoral reconstruction demonstrated significantly reduced prosthetic failure (odds ratio [OR] 0.30, 95% confidence interval [CI] 0.14-0.65) and unplanned reoperations (OR 0.43, 95% CI 0.24-0.77) compared with subpectoral reconstruction after controlling for implant characteristics and other possible confounders. Prepectoral patients experienced decreased animation deformity overall (19.7% vs. 0.0%, p < 0.001), with plane changes seen in 10.6% of subpectoral reconstructions for animation deformity correction. Prepectoral patients experienced an increase in rippling (15.3% vs. 6.1%, p = 0.003) without a significant increase in fat grafting (subpectoral = 11.6% vs. prepectoral = 12.3%, p = 0.829).
546			_aEnglish
650			_a*Breast Implantation
650			_a*Breast Implants
650			_a*Breast Neoplasms
650			_a*Mammaplasty
650			_aBreast Neoplasms/su [Surgery]
650			_aFemale
650			_aHumans
650			_aMammaplasty/ae [Adverse Effects]
650			_aMastectomy
650			_aNipples/su [Surgery]
650			_aPectoralis Muscles/su [Surgery]
650			_aRetrospective Studies
651			_aMedStar Washington Hospital Center
656			_aMedStar General Surgery Residency
656			_aSurgery/Plastic Surgery
657			_aJournal Article
700			_aFamiglietti, Amber
700			_aFan, Kenneth L
790			_aAvila A, Bartholomew AJ, Dekker PK, Famiglietti AL, Fan KL, King CA, Perez-Alvarez IM, Song DH, Sosin M, Tousimis EA
856			_uhttps://dx.doi.org/10.1245/s10434-021-10085-z _zhttps://dx.doi.org/10.1245/s10434-021-10085-z
942			_cART _dArticle
999			_c6801 _d6801