Photo Credit: Pradit Ph

The following is a summary of “Risk factors for residual fibroglandular breast tissue following a mastectomy – an overview and retrospective cohort study,” published in the July 2024 issue of Oncology by Christine et al.

Residual fibro glandular breast tissue (RFGT) post-mastectomy is a critical concern due to its association with remaining occult breast cancer and an elevated risk of local recurrence. Despite its significant implications, there is a lack of data on preventive measures for RFGT. Understanding the risk factors for RFGT is essential for identifying at-risk patients and tailoring surgical interventions to potentially mitigate this issue. To address this gap, the researchers conducted a comprehensive literature review and a retrospective cohort study involving patients who underwent mastectomy at the Department of Obstetrics and Gynecology, Medical University of Vienna, between January 1, 2015, and February 26, 2020. 

The primary objective was to evaluate differences in RFGT volumes across various mastectomy types. Secondary objectives included identifying additional risk factors for RFGT and comparing pre- and postoperative skin and subcutaneous fat tissue thickness. The analysis revealed that nipple-sparing mastectomy (NSM) resulted in significantly higher RFGT volumes compared to skin-sparing mastectomy (SSM) and radical mastectomy (RME) (p < 0.001). RFGT volume was also significantly associated with factors such as reconstruction (p = 0.012), use of acellular dermal matrix (ADM) or mesh (p = 0.031), patient age (p = 0.022), preoperative fibro glandular tissue volume (p = 0.012), and preoperative whole breast volume (p = 0.030). Furthermore, the reduction in postoperative skin envelope thickness, measured medially and laterally, was statistically significant in the NSM cohort (medial p < 0.001, lateral p = 0.001), while showing a numerical difference in the RME and SSM cohorts. 

The findings underscore the influence of mastectomy type, reconstruction techniques, ADM or mesh use, patient age, and preoperative breast characteristics on the risk of RFGT. The notable decrease in skin envelope thickness postoperatively suggests a need for careful surgical planning to avoid complications related to ischemia.

Source: bmccancer.biomedcentral.com/articles/10.1186/s12885-024-12491-4