ABSTRACT:
Background: Postmastectomy radiotherapy (PMRT) is a crucial adjunctive treatment in breast cancer management, yet it often leads to complications, particularly in patients with implant-based reconstruction. The positioning of implants, whether prepectoral or subpectoral, may influence the occurrence of complications. However, comparative studies investigating their impact on PMRT-related complications are limited.
Aim: This study aimed to explore comparative effect of prepectoral and subpectoral implant placement on complications following postmastectomy radiotherapy.
Methods: A retrospective cohort research was led at Jinnah Hospital, Lahore, spanning from November 2022 to November 2023.. A total of 120 patients who experienced mastectomy with instant implant-based reconstruction and subsequent PMRT were included. Sixty patients had prepectoral implant placement, while the remaining had subpectoral placement. Patient demographics, surgical characteristics, radiotherapy details, and complication rates were analyzed.
Results: Among the 120 patients, 60 underwent prepectoral implant placement, and the remaining had subpectoral placement. The occurrence of problems following PMRT was notably lower in prepectoral group associated to subpectoral group (p < 0.05). Specifically, rates of capsular contracture, implant malposition, and skin toxicity were significantly reduced in the prepectoral group.
Conclusion: Our findings suggest that prepectoral implant placement may confer a lower risk of complications following postmastectomy radiotherapy compared to subpectoral placement. This underscores the importance of considering implant position in reconstructive strategies for breast cancer patients undergoing PMRT.
Keywords: Breast cancer, postmastectomy radiotherapy, implant-based reconstruction, prepectoral, subpectoral, complications.