Use of the serratus anterior fascia in immediate implant-based breast reconstruction
DOI:
https://doi.org/10.29289/2594539420220051Palavras-chave:
serratus anterior fascia, breast reconstruction, breast implant, fascia, mastectomyResumo
ABSTRACT: Using the serratus anterior fascia may be a safe and effective option to recreate the lateral breast profile during subpectoral breast reconstruction, with minimal functional impact on the donor site. However, the literature is scarce when it comes to studies on this fascia flap in implant-based reconstruction. This article aimed to review the use of the serratus anterior fascia in immediate implant-based breast reconstruction, searching the electronic databases PubMed, Embase, Lilacs, and SciELO. The search was carried out by combining the following keywords: ‘breast reconstruction’ and ‘serratus anterior fascia’. In the Pubmed and Embase databases, the search yielded a total of 12 and 15 articles, respectively, of which seven were selected according to the scope of this article. We found no studies on serratus anterior fascia and breast reconstruction in the Lilacs and SciELO databases. All works have results favorable for the use of the serratus anterior fascia flap and agree that this technique can be considered in the algorithm for the coverage of the inferolateral portion during subpectoral breast reconstruction.
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Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-49. https://doi.org/10.3322/caac.21660
Instituto Nacional de Câncer. Estimativa 2023 – Incidência de câncer no Brasil. 2022 [cited on May 3, 2023]. Available from: https://www.gov.br/inca/pt-br/assuntos/cancer/numeros/estimativa
O'Connell RL, Rattay T, Dave RV, Trickey A, Skillman J, Barnes NLP, et al. The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study. Br J Cancer. 2019;120(9):883-95. https://doi.org/10.1038/s41416-019-0438-1
Baek SH, Bae SJ, Yoon CI, Park SE, Cha CH, Ahn SG, et al. Breast Reconstruction Does Not Have a Clinically Significant Impact on Adjuvant Treatment Delay and Subsequent Survival Outcomes. J Breast Cancer. 2019;22(1):109-19. https://doi.org/10.4048/jbc.2019.22.e7
Franceschini G, Scardina L, Leone A Di, Terribile DA, Sanchez AM, Magno S, et al. Immediate prosthetic breast reconstruction after nipple-sparing mastectomy: traditional subpectoral technique versus direct-to-implant prepectoral reconstruction without acellular dermal matrix. J Pers Med. 2021;11(2):153. https://doi.org/10.3390/jpm11020153
Gassman AA, Yoon AP, Maxhimer JB, Sanchez I, Sethi H, Cheng KW, et al. Comparison of postoperative pain control in autologous abdominal free flap versus implant-based breast reconstructions. Plast Reconstr Surg. 2015;135(2):356-67. https://doi.org/10.1097/PRS.0000000000000989
Duraes EFR, Schwarz GS, de Sousa JB, Duraes LC, Morisada M, Baker T, et al. factors influencing the aesthetic outcome and quality of life after breast reconstruction: a cross-sectional study. Ann Plast Surg. 2020;84(5):494-506. https://doi.org/10.1097/SAP.0000000000002157
Choi M, Frey JD, Alperovich M, Levine JP, Karp NS. "Breast in a Day": Examining Single-Stage Immediate, Permanent Implant Reconstruction in Nipple-Sparing Mastectomy. Plast Reconstr Surg. 2016;138(2):184e-91e. https://doi.org/10.1097/PRS.0000000000002333
Li L, Su Y, Xiu B, Huang X, Chi W, Hou J, et al. Comparison of prepectoral and subpectoral breast reconstruction after mastectomies: A systematic review and meta analysis. Eur J Surg Oncol. 2019;45(9):1542-50. https://doi.org/10.1016/j.ejso.2019.05.015
Salibian AA, Frey JD, Karp NS. Strategies and considerations in selecting between subpectoral and prepectoral breast reconstruction. Gland Surg. 2019;8(1):11-8. https://doi.org/10.21037/gs.2018.08.01
Saint-Cyr M, Dauwe P, Wong C, Thakar H, Nagarkar P, Rohrich RJ. Use of the serratus anterior fascia flap for expander coverage in breast reconstruction. Plast Reconstr Surg. 2010;125(4):1057-64. https://doi.org/10.1097/PRS.0b013e3181d17f61
Bordoni D, Cadenelli P, Rocco N, Tessone A, Falco G, Magalotti C. Serratus anterior fascia flap versus muscular flap for expander coverage in two-stage breast reconstruction following mastectomy: early post-operative outcomes. Aesthetic Plast Surg. 2017;41(1):26-30. https://doi.org/10.1007/s00266-016-0770-2
Alani HA, Balalaa N. Complete tissue expander coverage by musculo-fascial flaps in immediate breast mound reconstruction after mastectomy. J Plast Surg Hand Surg. 2013;47(5):399-404. https://doi.org/10.3109/2000656X.2013.772060
Seth AK, Hirsch EM, Kim JYS, Fine NA. Outcomes after elevation of serratus anterior fascia during prosthetic breast reconstruction. Ann Plast Surg. 2017;78(6):641-5. https://doi.org/10.1097/SAP.0000000000000967
Chan YH, Yue IK, Ho CM, Cheung PS. The use of serratus anterior fascial flap in integrated mastectomy and implant reconstruction. World J Surg. 2020;44(3):825-30. https://doi.org/10.1007/s00268-019-05275-6
Cristofari S, Bertrand B, Rem K, Revol M, Stivala A. The modified serratus anterior fascia flap improves satisfaction and long-term results in immediate implant-based breast reconstruction: a retrospective study. J Plast Reconstr Aesthet Surg. 2021;74(4):800-8. https://doi.org/10.1016/j.bjps.2020.10.014
Tarallo M, Lo Torto F, Ricci F, Dicorato P, Mori FLR, Vinci F, et al. Breast reconstruction after mastectomy with the use of an implant and serratus anterior fascia flap-initial clinical evaluation. J Pers Med. 2021;11(11):1142. https://doi.org/10.3390/jpm11111142
Kaplan J, Rohrich R. Breast implant illness: a topic in review. Gland Surg. 2021;10(1):430-43. https://doi.org/10.21037/gs-20-231
Dave RV, Vucicevic A, Barrett E, Highton L, Johnson R, Kirwan CC, et al. Risk factors for complications and implant loss after prepectoral implant-based immediate breast reconstruction: medium-term outcomes in a prospective cohort. Br J Surg. 2021;108(5):534-41. https://doi.org/10.1002/bjs.11964
Lam TC, Hsieh F, Salinas J, Boyages J. Immediate and long-term complications of direct-to-implant breast reconstruction after nipple- or skin-sparing mastectomy. Plast Reconstr Surg Glob Open. 2018;6(11):e1977. https://doi.org/10.1097/GOX.0000000000001977
Gschwantler-Kaulich D, Leser C, Salama M, Singer CF. Direct-to-implant breast reconstruction: Higher complication rate vs cosmetic benefits. Breast J. 2018;24(6):957-64. https://doi.org/10.1111/tbj.13113
Nahabedian MY. Implant-based breast reconstruction: strategies to achieve optimal outcomes and minimize complications. J Surg Oncol. 2016;113(8):895-905. https://doi.org/10.1002/jso.24210
Pusic AL, Matros E, Fine N, Buchel E, Gordillo GM, Hamill JB, et al. Patient-reported outcomes 1 year after immediate breast reconstruction: results of the mastectomy reconstruction outcomes consortium study. J Clin Oncol. 2017;35(22):2499-506. https://doi.org/10.1200/JCO.2016.69.9561
Brasil. Lei no 12.802 de 24 de abril de 2013. Diário Oficial da União [Internet]. 2013 [cited on May 3, 2023]. Available from: https://www.planalto.gov.br/ccivil_03/_ato2011-2014/2013/lei/l12802.htm
Freitas-Júnior R, Gagliato DM, Moura Filho JWC, Gouveia PA, Rahal RMS, Paulinelli RR, et al. Trends in breast cancer surgery at Brazil's public health system. J Surg Oncol. 2017;115(5):544-9. https://doi.org/10.1002/jso.24572
Susarla SM, Ganske I, Helliwell L, Morris D, Eriksson E, Chun YS. Comparison of clinical outcomes and patient satisfaction in immediate single-stage versus two-stage implant-based breast reconstruction. Plast Reconstr Surg. 2015;135(1):1e-8e. https://doi.org/10.1097/PRS.0000000000000803
Salgarello M, Barone-Adesi L, Terribile D, Masetti R. Update on one-stage immediate breast reconstruction with definitive prosthesis after sparing mastectomies. Breast. 2011;20(1):7-14. https://doi.org/10.1016/j.breast.2010.11.005
Colwell AS, Christensen JM. Nipple-sparing mastectomy and direct-to-implant breast reconstruction. Plast Reconstr Surg. 2017;140(5S Advances in Breast Reconstruction):44S-50S. https://doi.org/10.1097/PRS.0000000000003949
Galimberti V, Vicini E, Corso G, Morigi C, Fontana S, Sacchini V, et al. Nipple-sparing and skin-sparing mastectomy: Review of aims, oncological safety and contraindications. Breast. 2017;34 Suppl 1(Suppl 1):S82-4. https://doi.org/10.1016/j.breast.2017.06.034
Winters ZE, Afzal M, Rutherford C, Holzner B, Rumpold G, da Costa Vieira RA, et al. International validation of the European Organisation for Research and Treatment of Cancer QLQ-BRECON23 quality-of-life questionnaire for women undergoing breast reconstruction. Br J Surg. 2018;105(3):209-22. https://doi.org/10.1002/bjs.10656
Weber WP, Haug M, Kurzeder C, Bjelic-Radisic V, Koller R, Reitsamer R, et al. Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy. Breast Cancer Res Treat. 2018;172(3):523-37. https://doi.org/10.1007/s10549-018-4937-1
Salibian AA, Frey JD, Karp NS. Strategies and considerations in selecting between subpectoral and prepectoral breast reconstruction. Gland Surg. 2019;8(1):11-8. https://doi.org/10.21037/gs.2018.08.01
Okumura S, Hyodo I, Iwata H, Kamei Y. Immediate one-stage implant-based breast reconstruction without the use of acellular dermal matrix in Japanese breast cancer patients. Breast Cancer. 2020;27(4):759-64. https://doi.org/10.1007/s12282-020-01073-4
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