ArticleBreast cancer (Dove Medical Press)2026
A Brand-New Drainage Fluid Predictor, ICAM-1 for Implant Loss After the Immediate Reconstruction of Breast.
Article in Breast cancer (Dove Medical Press), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Nearly 40% of breast cancer patients are ineligible for breast-conserving surgery. Immediate implant-based breast reconstruction is a preferred option for these patients. The most severe complication of this procedure is implant loss. Currently, there are no cytokines available to predict implant failure. To identify a drainage biomarker predicting implant loss and evaluate whether dexamethasone irrigation in high-risk cases is associated with reduced implant failure, we designed this study. Methods: A retrospective cohort study was conducted between December 2022 and March 2024, patients undergoing mastectomy with immediate implant-based reconstruction were recruited. We applied protein microarray to analyze cytokines in the drainage fluid from the implant pocket to identify cytokines associated with implant failure. Results: We initially selected 3 patients with implant failure and 3 with successful implant outcomes as the cohort for protein microarray analysis. Drainage fluid samples were collected and analyzed at 3 time points: 24 hours postoperatively, at drainage removal and at the onset of implant failure. This analysis identified intercellular adhesion molecule-1 (ICAM-1) as a candidate marker that meets the criteria for predicting implant failure. Subsequently, we validated ICAM-1's predictive potential in a separate cohort of breast cancer patients who underwent immediate implant-based breast reconstruction between December 2022 and March 2024. Our results demonstrated that ICAM-1 levels in drainage fluid at the time of drainage removal effectively predicted implant failure following immediate breast reconstruction for breast cancer. Additionally, a retrospective analysis revealed that intracavitary irrigation with dexamethasone significantly reduced ICAM-1 level in the drainage fluid and reversed impending implant failure. Conclusion: The data confirmed the potential of ICAM-1 as a predictive factor for breast implant failure. Intracavitary irrigation with dexamethasone was effective to prevent implant loss.
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