P232 A study to evaluate the safety and utility of targeted axillary dissection using Guiding-Marker System

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acellular dermal matrices.In this retrospective study we compared clinical and oncological outcomes between prepectoral and subpectoral IBBR.Methods: A series of 554 consecutive patients with breast cancer that underwent conservative mastectomy with one stage prepectoral or subpectoral IBBR in our Institution from January 2018 to September 2022 were retrospectively reviewed.Results: In 380 of the 554 patients that received conservative mastectomy and immediate IBBR, the implant was positioned in a prepectoral plane (P-group) while in 174 in a subpectoral plane (S-group).Mean age was 47.7 (24-80) and 44.4 (18-70) years respectively.Nipple-sparing mastectomy was performed in 501 patients (340 in P-group and 161 in S-group); skin-sparing mastectomy in 48 patients (35 in P-group and 13 in S-group); 5 patients received a bilateral skinreducing mastectomy (all in P-group).Unilateral mastectomy was performed in 398/554 patients (71.8%) and bilateral mastectomy in 156/554 (28.2%).Simultaneous contralateral symmetrization was deemed necessary in 110/380 patients (28.9%) of the P-group and in 69/174 (39.6%) patients of the S-group.Mean operative time was shorter for prepectoral IBBR as compared to subpectoral IBBR both in patients undergoing bilateral mastectomy (268 min vs 307 min) and in patients undergoing unilateral mastectomy (205 min vs 230 min).Average length of follow-up was 28 months (range, 1-59).No statistically significant differences were observed between the two groups in terms of overall complication rates and oncological outcomes.Major complications (implant explantation due to important hematoma after surgical revision or to infection) were observed in 1.1% of P-group and 1.2% of S-group.LR-DFS, DDFS and OS were 1.6% vs 1.7%, 2.1% vs 2.3% and 0.8% vs 0.6% respectively in the P and S group.Conclusion(s): In line with the recent literature, results of our study seem to confirm that prepectoral IBBR is a safe surgical option.It has similar oncological and clinical outcomes when compared to subpectoral technique, with significantly lower rates of prosthesis explantation.

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