Breast reconstruction
Media coverage
Daily Mail 2024 Campaigners are demanding an urgent probe into the safety of surgical mesh used in thousands of NHS breast cancer operations each year. They fear the material, used in breast reconstruction, is leaving women with life-changing injuries, chronic pain and relying on heavy duty pain killers. See our blog post to read the full story.
Mail Online 2021 – Linda Williams was diagnosed with aggressive cancer in her right breast in 2015, she had a mastectomy, followed by six months of chemotherapy and radiotherapy for a year. Linda took two years to recover, and then accepted the offer of breast reconstruction. She underwent a transverse rectus abdominus muscle flap, where muscle, fat and skin are taken from the stomach area to create a new breast. After removing the muscle, the surgeon may put in mesh to strengthen the stomach wall.
‘Immediately afterwards I started to have issues,’ she says. ‘I had a stabbing pressure in my left leg, perhaps from nerve damage. I couldn’t walk properly or put any significant pressure on the leg. My GP sent me for a scan and it showed the mesh inside my body. ‘That’s the first time I knew I’d even been given mesh. I was then told by the surgeons that there was nothing wrong with the mesh, that I was the only person who had ever complained.’
In 2018, she developed cancer in her left breast and had a second mastectomy and didn’t have ‘the strength to keep fighting’ about the mesh. ‘Surgeons now tell me they cannot remove it because if they did it would leave me at serious risk of hernias,’ she says. ‘I’ve beaten cancer twice but mesh has ruined my life.’
Research
Restore B – UK hospitals are running a trial on mesh vs non mesh added into breast reconstruction surgeries following mastectomy, but if you look at the patient information leaflet, women are not being warned on mesh risks. A terrible situation for a vulnerable cohort of women. The research is being led by Oxford University.
Cureus Study shows almost a third of women experience complications following mastectomy using mesh – yet the conclusion states that using mesh is safe with low major complications rates.
Benefits and risks with acellular dermal matrix (ADM) and mesh support in immediate breast reconstruction: a systematic review and meta-analysis
In modern implant-based immediate breast reconstruction, it has become common to use biological acellular dermal and synthetic matrices in combination with a tissue expander or an implant. The aim of this systematic review was to examine differences in recurrence of cancer, impact on oncological treatment, health-related quality of life, complications and aesthetic outcome between matrix and no matrix in immediate breast reconstruction.
It concluded: “There is a lack of high-quality studies that compare the use of matrix with no matrix in immediate breast reconstruction. Specifically, there are no data on risk of recurrence of cancer, delay of adjuvant treatment and health-related quality of life. In addition, there is a risk of bias in many studies.
“Controlled trials that further analyse the impact of radiotherapy, type of matrix and type of procedure (one or two stages) are necessary.”
Journal of Plastic Surgery and Hand Surgery 52(3): 130-147. June 2018.
The use of mesh versus primary fascial closure of the abdominal donor site when using a transverse rectus abdominis myocutaneous flap for breast reconstruction: a cost-utility analysis
The authors‘ goal was to determine whether it is cost-effective to use mesh during abdominal donor-site closure when performing a transverse rectus abdominis myocutaneous (TRAM) flap for breast reconstruction. It concluded the use of mesh “when repairing the abdominal donor site during a pedicled or free TRAM flap breast reconstruction is cost effective compared with primary fascial closure alone”…
Plastic and Reconstructive Surgery 135(3): 682-689. March 2015.
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