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Background: Residual fibroglandular breast tissue (RFGT) following a mastectomy has been claimed to be associated with the occurrence of an in-breast local recurrence (IBLR) or new primary tumor (NP). Yet, scientific evidence proving this assumption is lacking. The primary aim of the study was to verify whether RFGT following a mastectomy is a risk factor for an IBLR or NP., Methods: This retrospective analysis included all patients that underwent a mastectomy and were followed up at the Department of Obstetrics and Gynecology of the Medical University of Vienna between 01.01.2015 and 26.02.2020. RFGT volume (assessed on magnetic resonance imaging) was correlated with the prevalence of an IBLR and a NP., Results: A total of 105 patients (126 breasts) following a therapeutic mastectomy were included. After a mean follow-up of 46.0 months an IBLR had occurred in 17 breasts and a NP in 1 breast. A significant difference in RFGT volume was observed between the disease-free cohort and the subgroup with an IBLR or NP (p = .017). A RFGT volume of ≥ 1153 mm 3 increased the risk by the factor 3.57 [95%CI 1.27; 10.03]., Conclusions: RFGT volume is associated with an increased risk for an IBLR or NP., (© 2023. The Author(s).)

Abstract Background Residual fibroglandular breast tissue (RFGT) following a mastectomy is associated with the remaining of occult breast cancer at the time of mastectomy as well as an increased local recurrence risk thereafter. Despite its oncologic implications, data on measures to prevent RFGT are lacking. Therefore, in a first step knowledge of risk factors for RFGT is of uttermost importance in order to allow identification of patients at risk and subsequently adaption of the surgical treatment and potentially prevention of RFGT a priori. Methods We performed a systematic literature review in PubMed using the MESH terms [residual fibroglandular breast tissue], [residual breast tissue], [mastectomy] and [risk factor] followed by a retrospective data analysis including all patients with a mastectomy treated at the Department of Obstetrics and Gynecology of the Medical University of Vienna, Austria, between 01.01.2015 and 26.02.2020 in order to identify risk factors of RFGT following a mastectomy. The primary aim of the study was to assess a potential difference in RFGT volume between the different types of mastectomy. The secondary objectives of the study were to identify other potential risk factors for RFGT as well as to compare the skin and subcutaneous fat tissue thickness pre- to postoperatively. Results Significantly higher RFGT volumes were observed following a nipple-sparing mastectomy (NSM) compared to a skin-sparing mastectomy (SSM) and radical mastectomy (RME) (p

Germline variations in the BRCA‐1 and BRCA‐2 genes are associated with an increased risk of breast cancer. These variants are found in 5% of all breast cancer cases. Prophylactic mastectomy is the most effective risk‐reducing method and shows high rates of patient satisfaction and acceptance. We established a registry of Austrian BRCA‐1 and BRCA‐2 mutation carriers who had undergone mastectomy for oncologic or prophylactic reasons. Data were collected on the type of operation, complications, and type of reconstructive surgery for patients between 2014 and 2017. The complication rate in patients with nipple‐sparing mastectomy was significantly lower (23.1%) than in those with other types of mastectomies (60.7%; P =.005). In patients with implant‐based breast reconstruction, subpectoral placement was associated with a significantly higher rate of complications than prepectoral placement (P =.025). Median implant volume was 350 cc (range: 155‐650 cc), and a 100‐cc increase was associated with doubling of the odds of a complication (regression coefficient = 0.007); based on this finding, some surgeons may decide on using smaller implants. In summary, we identified significant associations between the risk of complications and surgical characteristics, and found host factors like diabetes, BMI, and smoking among Austrian patients with BRCA‐1 and BRCA‐2 variants. [ABSTRACT FROM AUTHOR]

Background: Since skin‐ and nipple‐sparing mastectomies (SSM/NSM) are now considered oncologically safe options, the number of immediate implant‐based breast reconstructions (IBBR) has increased. We present our experience with different techniques of immediate and delayed IBBR over a period of 5 years. Methods: A single center, retrospective, cohort study was performed from January 2008 to January 2013. Complications, reconstructive failure, contralateral adjustment, cosmetic outcome, patient's quality of life, and the thickness of the overlying tissue were compared between different techniques of immediate and delayed IBBR. Results: A total of 180 patients who underwent immediate (n = 148, 82.2%) or delayed (n = 32, 17.8%) IBBR after SSM (n = 62, 34.4%), NSM (n = 21, 11.7%), or total mastectomy (n = 97, 53.9%) were included. The mean follow‐up was 46 months. Immediate IBBR was associated with better cosmetic outcomes (P = 0.026), fewer surgical interventions (P = 0.017), and better quality of life (P = 0.004). Patients with NSM showed the best quality of life results (P =< 0.001) and the best cosmetic outcome (P = 0.001). While immediate IBBR with direct‐to‐implant procedures achieved a trend toward best cosmetic outcomes (P = 0.66), it was associated with the highest complication rate (37.1%) compared to permanent expanders (10.5%) and a two‐stage expander‐to‐implant procedure (22.9%; P = 0.013) without a significant difference in the rate of implant loss (P = 0.51). Conclusion: Whenever oncologically feasible, immediate IBBR should be offered to the patient. The advantages of immediate IBBR with a direct‐to‐implant procedure such as better cosmetic outcome and fewer surgical interventions should be weighed up against the relatively high overall complication rate associated with this procedure. [ABSTRACT FROM AUTHOR]