Comparison of Wound Closure Using Acellular Dermal Matrix With Primary Wound Closure After Breast Conserving Surgery in Breast Cancer Patients

Abstract

Purpose: As breast-conserving surgery has become a standard treatment for patients with breast cancer, several approaches have been devised to achieve desirable cosmetic results, including a method using a patient’s own tissues or organs or a mesh to resolve defects. However, its application has been limited due to the associated complications. Accordingly, breast reconstruction using an acellular dermal matrix (ADM) has been introduced to improve patients’ cosmetic satisfaction. However, the comparison of reconstruction and primary sutures using this method has not been well-studied. Therefore, this study surveyed patients who underwent breast cancer surgery based on cosmetic indicators to study the efficacy of ADM after breast-conserving surgery.Methods: This retrospective study included 68 patients diagnosed with breast cancer who underwent breast-conserving surgery at a single institution by a single surgeon from April 2019 to December 2020.Results: This study included 68 patients who underwent breast-conserving surgery. Among them, 22 patients underwent breast-conserving surgery using ADM, while 46 patients received only primary sutures without ADM. Among the items of the Breast Cancer Treatment Outcome Scale-12 (BCTOS-12), patient satisfaction was significantly higher in the group using ADM, than that in the control group in terms of breast shape (1.86±0.89 vs. 2.39±0.80, p=0.017). Regarding breast tenderness, the result also confirmed the group treated using ADM experienced less tenderness than the control group not treated with ADM (1.68±0.78 vs. 2.22±1.03, p=0.035). The two groups exhibited no significant differences in breast texture, arm heaviness, nipple appearance, shoulder discomfort, arm discomfort, scar tissue, arm swelling, breast swelling, fit of the bra, and breast sensitivity.Conclusion: Breast reconstruction using ADM in patients with breast cancer was effective from a cosmetic perspective. Prospective multicenter studies should be conducted to provide clear guidelines.