Comparative study of prosthesis implantation, latissimus dorsi flap, and combined reconstruction immediately after breast cancer surgery: A retrospective, single-center, observational cohort study

This study aimed to explore the effects of 3 immediate reconstruction methods – prosthesis implantation, latissimus dorsi flap (LDF), or their combination – on postoperative outcomes following breast cancer (BC) surgery. A retrospective, single-center, observational cohort study was conducted on 58 patients with BC who underwent immediate breast reconstruction at our hospital between June 2017 and June 2022. Patients were consecutively enrolled and categorized into 3 groups based on the reconstruction method: simple prosthesis implantation (n = 19), LDF reconstruction (n = 19), and a combination group (prosthesis implantation + LDF, n = 20). Outcomes, including postoperative drainage time, hospital stay duration, Strategies Used by People to Promote Health score, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 items score, aesthetic satisfaction, and complication rates, were compared across groups. Statistical analyses were performed using one-way analysis of variance followed by Tukey’s honestly significant difference test for continuous variables and chi-square tests for categorical variables, with a significance threshold of P  < .05. No significant differences were observed in postoperative drainage time or hospital stay duration among the 3 groups ( P  > .05). Following surgery, Strategies Used by People to Promote Health and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 items scores improved significantly in all groups, with the combination group demonstrating the highest scores, followed by the LDF group, and then the simple prosthesis group ( P  < .05). Similarly, aesthetic satisfaction (excellent/good rates) was highest in the combination group, followed by the LDF group, and then the simple prosthesis group ( P  < .05). The overall complication rates did not differ significantly among the groups ( P  > .05). This study suggests that LDF combined with immediate prosthesis implantation may be an effective option for breast reconstruction after early BC surgery, offering favorable aesthetic outcomes and patient satisfaction. However, further prospective studies with larger sample sizes are warranted to confirm these findings and establish clinical recommendations.