Evidence map›Paper›PMID 38905789›Full record

ArticleJournal of plastic, reconstructive & aesthetic surgery : JPRAS2024

National trends in revision procedures in post-mastectomy breast reconstruction: Autologous vs implant-based approaches.

Shannon D Francis, Augustine W Kang, Bhagvat J Maheta, Brian R Sangalang, Sophia Salingaros, Robin T Wu, Rahim S Nazerali

Abstract read
In one paragraph

Article in Journal of plastic, reconstructive & aesthetic surgery : JPRAS, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Shannon D FrancisStanford University School of Medicine, Stanford, CA, USA.
Augustine W KangStanford University School of Medicine, Stanford, CA, USA.
Bhagvat J MahetaCalifornia Northstate University College of Medicine, Elk Grove, CA, USA.
Brian R SangalangUniversity of California Riverside School of Medicine, Riverside, CA, USA.
Sophia SalingarosWeill Cornell Medical College, New York City, NY, USA.
Robin T WuDivision of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Rahim S NazeraliDivision of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: rahimn@stanford.edu.

Funding

Stanford Center for Clinical & Translational Education and Research (Spectrum)UL1TR003142 · NCATS · STANFORD UNIVERSITY · PI O'HARA, RUTH M · 2019 to 2023
$45.0M
NCATS NIH HHS UL1 TR003142
6 · The paper itself

Abstract

backgroundBreast reconstruction involves collaborative decision-making between patients and surgeons, but the need for multiple revisions after the initial reconstructive surgery process can burden patients and the healthcare system. This study explored how the type of breast reconstruction (autologous [ABR], immediate implant-based reconstruction [IBR], or two-stage IBR) impacts postreconstruction revision rates.

methodUsing MarketScan Databases, a retrospective database study (2007-2021) was conducted, identifying revision procedures through Current Procedural Terminology codes. Statistical analysis with linear models, adjusted for patient characteristics and surgical factors, used a significance threshold of p < 0.05.

resultsAmong 58,264 patients, 6.2% of ABR patients, 3.8% of immediate IBR patients, and 3.6% of two-stage IBR patients underwent future revisions. IBR had a 51% lower incidence rate of revision operations than ABR (incidence rate ratio = 0.49, p < 0.001). Within IBR, there was no significant difference in the number of operations between immediate IBR (0.06 ± 0.32) and two-stage IBR (0.05 ± 0.32, p = 0.95). Immediate IBR demonstrated 12% (OR = 0.88, p = 0.0022) and 70% (OR = 0.30, p < 0.001) lower odds of requiring breast revision and fat grafting compared to ABR, respectively. Two-stage reconstruction had 66 % lower odds of requiring only fat grafting than ABR (OR = 0.34, p < 0.001).

conclusionABR necessitated a higher number of total revision procedures after completion of the initial reconstruction. These findings will better equip providers and patients to counsel patients in understanding their reconstructive journey, planning their reconstructions and timing, and provide more accurate estimates of the number of procedures that will be required to reach their aesthetic goals and final outcome.

Indexed as

Breast ImplantsBreast NeoplasmsMammaplastyMastectomyReoperationAdultBreast ImplantationFemaleHumansMiddle AgedRetrospective StudiesTransplantation, AutologousUnited StatesAutologous breast reconstructionBreast reconstructionImplant breast reconstructionRevisionTissue expander

Identifiers

PMID38905789
PMCPMC11465625

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.