Abstract
BACKGROUND: Breast cancer is the most common malignancy in women worldwide, and breast reconstruction following mastectomy is an integral part of patient care to improve quality of life and aesthetic outcomes. Nipple-sparing mastectomy (NSM) combined with immediate breast reconstruction (IBR) with implant is becoming increasingly preferred due to its ability to preserve breast aesthetics. Acellular dermal matrix (ADM) is commonly used in these procedures, but is often prohibitively expensive, particularly in resource-limited settings like Vietnam. Polypropylene mesh (PPM) has emerged as a more affordable alternative; however, its safety and effectiveness in NSM and IBR remain unknown, especially in low-resource healthcare environments. METHODS: This retrospective single-arm study included early breast cancer (EBC) patients who underwent NSM followed by IBR with PPM at a single institution between January 1, 2022, and January 31, 2024. The inclusion criteria were EBC stage 0, I, or II, with no prior neoadjuvant therapy or chest wall radiotherapy. Descriptive statistics were applied, and chi-square or Fisher's exact tests were used to assess associations between clinical variables and postoperative complications. RESULTS: Among the 37 patients, the mean age was 40.9 years (range: 25-57). Most (70.3%) had invasive carcinoma, and 73.0% were luminal/HER2-negative. High-profile implants were used in 76.7% of cases. Two patients (5.4%) experienced mild-to-moderate complications, including infection (2.7%) and nipple-areolar necrosis (2.7%). Both were treated successfully with medical therapy. No cases of implant loss occurred, and no significant associations were found between complications and clinical variables (p > 0.05). CONCLUSION: PPM use in IBR after NSM for EBC patients is a safe and viable option, with low complication rates. PPM may serve as a cost-effective alternative to ADM, particularly in resource-constrained settings, such as Vietnam. Larger studies are recommended to confirm these results and assess long-term outcomes.