Comparative analysis of clinical and functional results of one-stage and two-stage breast reconstruction after mastectomy in patients with large mammary glands

Vollständiger Abstract

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BACKGROUND : The advancement and refinement of surgical treatment approaches for breast carcinoma facilitate the preservation of a high quality of life in patients following reconstructive procedures, particularly in cases of substantial breast volume and pronounced ptosis. AIM : To compare the immediate and long-term outcomes and quality of life in patients undergoing two-stage versus one-stage reconstruction after skin-sparing mastectomy in breasts exceeding 150 mL in volume. METHODS : A retrospective analysis of treatment outcomes was conducted in 115 patients of comparison group 1 with a breast volume exceeding 150 mL. Supgroup 1 (n = 53) comprised patients who underwent mastectomy with two-stage (expander / implant) reconstruction in 2011–2015; group 2 (n = 62) comprised patients operated on in 2016–2020 using the newly developed “Method of reconstruction after subcutaneous mastectomy with preservation of the nipple-areolar complex in large breast volume with grade 3–4 ptosis” (patent RU 2654583 of 21.05.2018). Operative duration, blood loss, and postoperative complications (Clavien–Dindo classification) were documented. Disease-free and overall survival were evaluated using the Kaplan–Meier method; quality of life was measured using the Breast-Q questionnaire before surgery and 6 months after treatment. Parametric and non-parametric methods were employed at p