Comparison of the results of repeated reconstructive interventions on the breast using allo- and autologous materials. Experience of the P. Herzen Moscow Oncology Research Institute

Background. Breast reconstruction with allo- and/or autologous materials is becoming the most popular surgical treatment option for breast cancer patients. The aim of the study. To evaluate the efficacy of reconstructions in breast cancer patients depending on the technique of reintervention. Materials and methods. The object of the study was a group of 70 female patients who underwent repeat reconstruction using endoprosthesis, flap autografting, and/o r a combination of these methods, between 2016 and 2023. The age of the patients ranged from 25 to 68 years. The mean age was 46.8 ± 8.6 years. Body mass index (BMI) > 25 was in 56 % (n = 37) of patients, BMI < 25 – in 44 % (n = 33). Regarding the reconstructive option, the patients were divided into three groups: 1) reconstruction with endoprosthesis (tissue expander or silicone endoprosthesis) (n = 30; 42.8 %); 2) reconstruction with deep inferior epigastric artery perforator (DIEP) or transverse rectus abdominis myocutaneous (TRAM) flap (n = 20; 28.5 %); 3) combination of thoracodorsal flap (TDF) and endoprosthesis (n = 20; 28.5 %). Results. According to the data of the BREAST-Q questionnaire there was a significant increase of psychosocial and sexual well-being in the postoperative period in all groups. In the group of endoprosthesis reconstruction there was a pronounced dynamics of the growth of satisfaction with the mammary gland (before the operation – 50.3 points according to Rasch, after the operation – 84 points), despite several repeated operations. In case of TRAM-flap reconstruction (n = 5/20; 25 %) the patients noted a slight discomfort, difficulty in performing household physical activity during 6 months after the surgical treatment (before the operation – 46 points according to Rasch, after – 49 points). Among the interviewed patients, on average (11 points according to Rasch), an increase in satisfaction with the state of the anterior abdominal wall was noted. In the group of TDF + endoprosthesis reconstruction none of the interviewed patients noted discomfort, limitation and inability to perform everyday physical activity (preoperatively – 46 points according to Rasch, after – 49 points). Conclusion. The data of our study are comparable with the world results, both in terms of the approach to the choice of repeat reconstruction and the overall satisfaction of the patients.