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Research ArticleClinical Studies

Pre-pectoral Breast Reconstruction Does Not Affect Early Immunological Response: A BIAL 2.20 Study Subanalysis

GIANLUCA VANNI, MARCO PELLICCIARO, AMIR SADRI, FEDERICO TACCONI and MARCO MATERAZZO
Anticancer Research November 2021, 41 (11) 5657-5665; DOI: https://doi.org/10.21873/anticanres.15382
GIANLUCA VANNI
1Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy;
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MARCO PELLICCIARO
1Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy;
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  • For correspondence: marcopell62@gmail.com
AMIR SADRI
2Plastic Surgery, Great Ormond Street Hospital, London, U.K.;
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FEDERICO TACCONI
3Division of Thoracic Surgery, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
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MARCO MATERAZZO
1Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy;
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Abstract

Background/aim: Reduction of postoperative stress is a modern tenet in surgical oncology with the aim of reducing early postoperative lymphopenia. Our prospective study evaluated post-operative immune response at baseline and postoperative day (POD) 1 and 2 after direct-to-implant pre-pectoral (PP) breast reconstruction with titanium-coated polypropylene mesh versus subpectoral (SP) breast reconstruction. Patients and Methods: Between January and December 2020, 37 patients were randomized between PP (n=17) or SP (n=16) reconstruction. Baseline and operative data were analyzed. Postoperative pain assessment using numeric pain rating scale (NPRS), and a full blood count with lymphocyte subsets were collected before surgery, and on POD1 and POD2. Data were evaluated by two-way analysis of variance test. Results: Baseline data did not demonstrate any statistical difference. Inter-group analysis did not provide any statistically significant difference in leukocytes, total lymphocytes, and lymphocytes subsets among SP and PP reconstruction groups (p>0.05). However, compared to specificity, the PP group experienced shorter operative time, with a mean difference 30.19 min, lower blood loss (p=0.017), lower rate of postoperative anemia (p=0.039), and a more favorable profile in inter-group pain analysis (p<0.001). Conclusion: PP reconstruction with titanium-coated polypropylene mesh does not increase immunological impairment in the early postoperative period when compared with SP reconstruction and provides lower postoperative pain, reduction of operative time, and lower rate of postoperative anemia.

Key Words:
  • Breast neoplasm
  • immunosuppression
  • breast implants
  • surgical mesh
  • anemia
  • pain
  • postoperative
  • pre-pectoral breast reconstruction
  • titanium-coated polypropylene mesh
  • Received September 11, 2021.
  • Revision received September 27, 2021.
  • Accepted September 29, 2021.
  • Copyright © 2021 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 41 (11)
Anticancer Research
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November 2021
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Pre-pectoral Breast Reconstruction Does Not Affect Early Immunological Response: A BIAL 2.20 Study Subanalysis
GIANLUCA VANNI, MARCO PELLICCIARO, AMIR SADRI, FEDERICO TACCONI, MARCO MATERAZZO
Anticancer Research Nov 2021, 41 (11) 5657-5665; DOI: 10.21873/anticanres.15382

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Pre-pectoral Breast Reconstruction Does Not Affect Early Immunological Response: A BIAL 2.20 Study Subanalysis
GIANLUCA VANNI, MARCO PELLICCIARO, AMIR SADRI, FEDERICO TACCONI, MARCO MATERAZZO
Anticancer Research Nov 2021, 41 (11) 5657-5665; DOI: 10.21873/anticanres.15382
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Keywords

  • Breast neoplasm
  • immunosuppression
  • breast implants
  • surgical mesh
  • anemia
  • pain
  • postoperative
  • pre-pectoral breast reconstruction
  • titanium-coated polypropylene mesh
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