Clinical progression following acellular dermal matrix use for volume replacement after breast-conserving surgery

Abstract

Background: The cosmetic outcomes of breast-conserving surgery (BCS) have recently gained increasing attention, and surgeons are exploring the use of the acellular dermal matrix (ADM) as a safe and effective method of breast reconstruction. This study evaluated the clinical progress of patients with breast cancer following the application of sheet-type ADM for breast reconstruction after BCS. Methods: This retrospective study included 137 patients who underwent BCS using ADM at a single center between October 2019 and October 2021. During surgery, sheet-type ADM was folded and inserted into the excised defects. Complications and cancer recurrence were evaluated during surveillance follow-up until December 2023, and maintenance of the inserted ADM was quantitatively compared using volume analysis of the first and last follow-up computed tomography (CT). Results: Of the 137 evaluated patients, 16 (11.6%) had minor complications, and 17 (12.4%) underwent biopsy during the surveillance period. One patient was diagnosed with recurrence. ADM volume was measured in 55 patients. The mean volume reduction between the first and last CT scans was 1.81 ± 2.06 cm³ (a decrease of 17.42 ± 19.82%), which was statistically significant (p < 0.001). Conclusions: The insertion of ADM after BCS is a safe and effective method for addressing volume defects, even though a slight reduction occurs in ADM volume.