<abstract xmlns="http://www.w3.org/1999/xhtml"><p>The aim of the study was to analyze the reasons for removing implants after breast reconstruction in the course of treatment of breast cancer. The study involved 428 patients, who underwent a total of 648 breast reconstruction procedures using artificial implants. 47 out of 648 cases (7.3%) were identified in which the implant had to be removed. Of the 47 cases, 57.4% had undergone deferred reconstruction, and 42.6% immediate reconstruction; 27.7% had undergone pre-operative chemotherapy and radiotherapy, 27.7% pre-operative chemotherapy, and 2.1% pre-operative radiotherapy; 6.4% were diabetic, 4.3% active smokers, and more than 50.0% had BMI greater than 25 kg/m<sup>2</sup>. In 83.0% of the analyzed cases, the reason for removal of the implant was infection, in 8.5% it was local recurrence of breast cancer, in 4.3% it was damage (leakage) of the implant, and in 2.1% it was post-operative pain. About 87.0% of infections appeared within one year of implantation; however, less than a half developed within 90 days of the reconstructive surgery, and up to 30 days only about 13.0% had appeared. Among the etiological agents of infections were: coagulase-negative <italic>Staphylococcus</italic> (31.3%), <italic>Staphylococcus aureus</italic> (18.7%), <italic>Enterococcus faecalis</italic> (9.4%), <italic>Enterobacter cloacae</italic> (18.8%), <italic>Pseudomonas aeruginosa</italic> (12.5%), <italic>Acinetobacter lwoffii</italic> (3.1%), and other Gram-negative fermenting rods accounted for 6.2%. Infections were the most common reason for removing the implant after breast reconstruction. and occurred most often as late infections (>30 days after surgery). The time of observation for infectious complications should be at least 1 year.</p></abstract>

The aim of the study was to analyze the reasons for removing implants after breast reconstruction in the course of treatment of breast cancer. The study involved 428 patients, who underwent a total of 648 breast reconstruction procedures using artificial implants. 47 out of 648 cases (7.3%) were identified in which the implant had to be removed. Of the 47 cases, 57.4% had undergone deferred reconstruction, and 42.6% immediate reconstruction; 27.7% had undergone pre-operative chemotherapy and radiotherapy, 27.7% pre-operative chemotherapy, and 2.1% pre-operative radiotherapy; 6.4% were diabetic, 4.3% active smokers, and more than 50.0% had BMI greater than 25 kg/m2. In 83.0% of the analyzed cases, the reason for removal of the implant was infection, in 8.5% it was local recurrence of breast cancer, in 4.3% it was damage (leakage) of the implant, and in 2.1% it was post-operative pain. About 87.0% of infections appeared within one year of implantation; however, less than a half developed within 90 days of the reconstructive surgery, and up to 30 days only about 13.0% had appeared. Among the etiological agents of infections were: coagulase-negative Staphylococcus (31.3%), Staphylococcus aureus (18.7%), Enterococcus faecalis (9.4%), Enterobacter cloacae (18.8%), Pseudomonas aeruginosa (12.5%), Acinetobacter lwoffii (3.1%), and other Gram-negative fermenting rods accounted for 6.2%. Infections were the most common reason for removing the implant after breast reconstruction. and occurred most often as late infections (>30 days after surgery). The time of observation for infectious complications should be at least 1 year.

Significance of Infections in Implant Loss After Breast Reconstruction in the Course of Breast Cancer Treatment

Polish Journal of Microbiology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

The aim of the study was to analyze the reasons for removing implants after breast reconstruction in the course of treatment of breast cancer. The study...

Characteristics	Number of cases n = 47n (%)
Infection
Early (≤ 30 days)	6 (12.8)
Late (> 30 days)
31-90 days	11 (23.4)
91-365 days	17 (36.2)
> 365 days	5 (10.6)
– Local recurrence of breast cancer	2 (4.3)
– Local recurrence of breast cancer in the chest wall	2 (4.3)
– Postoperative pain	1 (2.1)
– Leakage of prosthesis/expander prosthesis	2 (4.3)
– No data	1 (2.1)

Characteristics	Number of cases n = 47n (%)
Type of carcinoma
Ductal carcinoma	36 (76.6)
Lobular carcinoma	2 (4.3)
Other forms of invasive cancer	3 (6.4)
DCIS	4 (8.5)
No data	2 (4.3)
Clinical stage (cTNM)
IA	14 (29.8)
IIA	17 (36.2)
IIB	5 (10.6)
IIIA	2 (4.3)
IIIB	1 (2.1)
No data	8 (17.0)
Diabetes
Yes	3 (6.4)
No	44 (93.6)
Nicotinism
Yes	2 (4.3)
No	36 (76.6)
No data	9 (19.1)
BMI [kg/m²]
< 25	21 (44.7)
≥ 25	26 (55.3)
MSSA carrier
Yes	8 (17.0)
No	26 (55.3)
No data	13 (27.7)
Type of reconstruction
Immediate	20 (42.6)
Deferred	27 (57.4)
Type of implant
Expander	23 (48.9)
Expander prosthesis	8 (17.0)
Prosthesis	5 (10.6)
Expander prosthesis/prosthesis (2^nd stage of reconstruction - replacement of implant after earlier implantation of expander)	11 (23.4)

Characteristic	Number of cases n = 47n (%)
Pre-implantation treatment:
– RTH	1 (2.1)
– CHTH	13 (27.7)
– RTH+CHTH	13 (27.7)
– No treatment	19 (40.4)
– No data	1 (2.1)
Post-implantation treatment:
– RTH	1 (2.1)
– CHTH	4(8.5)
– RTH+CHTH	1 (2.1)
– No treatment	40 (85.1)
– No data	1 (2.1)

Significance of Infections in Implant Loss After Breast Reconstruction in the Course of Breast Cancer Treatment

Article Category: original-paper

Publicado en línea: 03 sept 2019

Páginas: 343 - 351

Recibido: 17 abr 2019

Aceptado: 14 jul 2019

DOI: https://doi.org/10.33073/pjm-2019-037

Palabras clave
breast cancer, implants, infections, etiological agents

© 2019 Anton Pyskun et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1.

Characteristics of postoperative complications.

Clinical and histopathological characteristics of patients with implant loss, and the type of reconstruction.

Characteristics of pre- and post-implantation treatment of cancer patients.

Significance of Infections in Implant Loss After Breast Reconstruction in the Course of Breast Cancer Treatment

Article Category: original-paper

Publicado en línea: 03 sept 2019

Páginas: 343 - 351

Recibido: 17 abr 2019

Aceptado: 14 jul 2019

DOI: https://doi.org/10.33073/pjm-2019-037

Palabras clavebreast cancer, implants, infections, etiological agents

© 2019 Anton Pyskun et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1.

Characteristics of postoperative complications.

Clinical and histopathological characteristics of patients with implant loss, and the type of reconstruction.

Characteristics of pre- and post-implantation treatment of cancer patients.

Palabras clave
breast cancer, implants, infections, etiological agents