September 29, 2017
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Auto-augmentation techniques demonstrate acceptable complication rates

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Women undergoing breast reconstruction using auto-augmentation techniques experienced similar complication rates as those undergoing traditional interventions.

Using a prospectively maintained database, the researchers gathered data for 333 women undergoing partial mastectomy or oncoplastic reductions between 1994 and October 2015. The analysis included 111 women who underwent auto-augmentation and 222 who did not. Auto-augmentation was defined as extended primary nipple auto-augmentation pedicle, and primary nipple pedicle and secondary auto-augmentation pedicle, according to the researchers.

Extended auto-augmentation pedicle was reported in 51 patients, while 60 experienced a secondary auto-augmentation pedicle.

Patients in the extended pedicle group had the lowest biopsy weight (136 g) and those in the regular oncoplastic group had the highest biopsy weight (235 g; P = .017).

The most common extended pedicle was the superomedial, while the lateral was the most common location, according to the results. The researchers added that the most commonly reported secondary pedicle for lateral and upper outer defects was inferorolateral.

Complications occurred in 15.5% of patients in the regular oncoplastic arm, 19.6% of those in the extended pedicle arm, and 20% of those in the secondary pedicle arm.

Nipple necrosis occurred in 1.4% of women overall. No statistically significant differences were reported among the study groups in terms of nipple necrosis (P = .679) and fat necrosis (P = .378).

Other adverse outcomes, including delayed wound healing, infection, skin necrosis, hematoma and seroma rates, were similar across the treatment arms.

“Auto-augmentation techniques have evolved to manage complex defects not amenable to standard oncoplastic reduction methods,” the researchers concluded. “They are often required for lateral defects especially in smaller breasts. Auto-augmentation can be done safely without increase risk of complications, broadening the indications for breast conservation therapy.” – by Rob Volansky

Disclosures: The authors report no relevant financial disclosures.