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QS1. The impact of polyurethane coated implants on the risk of capsular contracture after immediate prepectoral breast reconstruction in the setting of postmastectomy radiotherapy: the OPBC-09 PRExRT study.

Thursday, March 5, 2026
10:07 AM - 10:11 AM MST
Location: Breast/Endocrine HUB Zone

    Primary Author(s)

  • FF

    Florian Fitzal, MD, MBA

    Chief of Breast Reconstruction
    Krankenhaus Hanusch, General Surgery and Breast Health Center Vienna
    Wien, Wien, Austria

    • Primary Presenter(s)

  • Rama Kiblawi, MD (she/her/hers)

    Resident and Research Fellow
    Breast clinic University Hospital Basel
    Basel, Basel-Stadt, Switzerland

    Slides

    • Co-Author(s)

  • FH

    Florian Halbeisen, PhD

    Surgical Outcome Research Center, University Hospital Basel and University of Basel
    Basel, Basel-Stadt, Switzerland

  • GF

    Gianluca Franceschini, MD

    Breast Unit, Department of Science and Health of Women, Children and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome,
    Roma, Lazio, Italy

  • Lorenzo Scardina, MD (he/him/his)

    Consultant Breast Surgeon
    Breast Unit, Department of Science and Health of Women, Children and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome
    Roma, Lazio, Italy

  • FM

    Fabio Marazzi, MD

    Department of Radiation Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome
    Roma, Lazio, Italy

  • DV

    Dario Virzi, MD

    Plastic Surgery Unit, Humanitas Istituto Clinico Catanese, Misterbianco, Catania
    Catania, Sicilia, Italy

  • KB

    Konstantina Balafa, MD

    Breast Surgery Unit, Humanitas Center, Catania
    Catania, Sicilia, Italy

  • MM

    Maja Molska, MD

    Clinical Department of General and Oncological Surgery, University Hospital in Zielona Góra, Zielona Góra
    Zielona Góra, Lubuskie, Poland

  • OB

    Oliwia Bednarek, MD

    Clinical Department of General and Oncological Surgery, University Hospital in Zielona Góra
    Zielona Góra, Lubuskie, Poland

  • Martin Heidinger, MD (he/him/his)

    Fellow
    University Hospital Basel
    Basel, Basel-Stadt, Switzerland

    Slides

  • Edvin Ostapenko, MD, PhD

    Edvin Ostapenko
    Faculty of Medicine, Vilnius University
    Vilnius, Vilniaus Apskritis, Lithuania

  • KA

    Khaled Mohamed Abdelwahab, MD

    Mansoura Oncology Center, Surgical Oncology Department, Faculty of Medicine, Mansoura University, Mansoura
    Mansoura, Ad Daqahliyah, Egypt

  • Amit Agrawal, MD (he/him/his)

    Consultant Breast Surgeon, Associate Professor
    Department of Breast Surgery, Cambridge University Hospitals, Cambridge
    Cambridge, England, United Kingdom

  • MB

    Maggie Banys-Paluchowski, MD, PhD (she/her/hers)

    Prof. Dr. med.
    Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck
    Lübeck, Schleswig-Holstein, Germany

  • GK

    Guldeniz Karadeniz Cakmak, MD

    Department of General Surgery, School of Medicine, Zonguldak Bulent Ecevit University, Zonguldak
    Zonguldak, Zonguldak, Turkey

  • EG

    Eduardo Gonzalez, MD

    Department of Senology, Senology Unit, Sanatorio Modelo Quilmes, University of Buenos Aires
    Buenos Aires, Buenos Aires, Argentina

  • MH

    Martin D. Haug, MD

    Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel
    Basel, Basel-Stadt, Switzerland

  • LH

    Laura Henderson, MD

    Department of Breast Surgery, Cambridge University Hospitals, Cambridge
    Cambridge, England, United Kingdom

  • EK

    Elisabeth A. Kappos, MD

    University of Basel and Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel
    Basel, Basel-Stadt, Switzerland

  • MK

    Michael Knauer, MD

    Tumor and Breast Center Eastern Switzerland, St. Gallen
    St. Gallen, Sankt Gallen, Switzerland

  • JL

    Jaime Letzkus B., MD

    Breast Surgical Unit, San Borja Arriarán Clinical Hospital-Clínica MEDS, Santiago
    Santiago, Region Metropolitana, Chile

  • Giacomo Montagna, MD, MPH

    Breast Service, Department of Surgery
    Memorial Sloan Kettering Cancer Center
    New York, New York, United States

  • MR

    Martín Rivas Ibarra, MD

    Department of Breast Surgery, Arturo López Pérez Foundation
    Santiago, Region Metropolitana, Chile

  • SR

    Simone Ross, PhD

    Surgical Outcome Research Center, University Hospital Basel and University of Basel
    Basel, Basel-Stadt, Switzerland

  • DS

    Dirk J. Schaefer, MD

    Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel
    Basel, Basel-Stadt, Switzerland

  • NS

    Nicole Speck, MD

    Dr.
    Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel
    Basel, Basel-Stadt, Switzerland

  • NT

    Nikolas Tauber, MD

    Department of Gynecology and Obstetrics, University Hospital Schleswig-Holstein, Campus Lübeck
    Lübeck, Schleswig-Holstein, Germany

  • JV

    José H. Volders, MD, PhD

    Department of Surgical Oncology, Diakonessenhuis, Utrecht
    Utrecht, Utrecht, Netherlands

  • Denise Vorburger, MD (she/her/hers)

    Consultant Breast Surgeon
    Breast Center, Department of Gynecology, Winterthur Cantonal Hospital
    Winterthur, Zurich, Switzerland

  • JB

    Justin M. Broyles, MD

    Division of Breast Surgery, Brigham and Women's Hospital, Dana Farber/Brigham Cancer Center, Boston
    Boston, Massachusetts, United States

  • LS

    Lisa Stenman Skarsgård, MD

    Department of Plastic and Reconstructive Surgery, Oslo University Hospital
    Oslo, Oslo, Norway

  • CK

    Christian Korvald, MD, PhD

    Department of Plastic and Reconstructive Surgery, Oslo University Hospital
    Oslo, Oslo, Norway

  • CK

    Cynthia Kohl, MD

    Interdisciplinary Breast Center, Kliniken Essen-Mitte, Essen
    Essen, Nordrhein-Westfalen, Germany

  • FT

    Franziska Trapp, MD

    Interdisciplinary Breast Center, Kliniken Essen-Mitte, Essen
    Esse, Nordrhein-Westfalen, Germany

  • SG

    Simona Gipe, MD

    Interdisciplinary Breast Center, Kliniken Essen-Mitte, Essen
    Essen, Nordrhein-Westfalen, Germany

  • DP

    Daniele Passeri, MD

    Veneto Institute of Oncology - IRCCS, Padova
    Padova, Veneto, Italy

  • MT

    Mariacristina Toffanin, MD

    Veneto Institute of Oncology - IRCCS, Padova
    Padova, Veneto, Italy

  • MF

    Massimo Ferrucci, MD, PhD

    Veneto Institute of Oncology
    Veneto Institute of Oncology
    Padova, Veneto, Italy

Introduction: Patients with breast cancer undergoing mastectomy with implant-based breast reconstruction (IBBR), who are at high risk of locoregional recurrence, often require postmastectomy radiotherapy (PMRT), which increases the risk of capsular contracture (CC). The present study assessed the association between use of polyurethane coated (PUc) versus non-PUc implants and the need for surgical revision due to CC in the setting of PMRT.


Methods: This international multicenter retrospective real-world study included patients with breast cancer who underwent nipple- (NSM) or skin-sparing mastectomy (SSM) with prepectoral IBBR with or without PUc implants followed by PMRT. Primary endpoint was surgical revision due to CC and was analyzed using Cox regression models.


Results:  1183 women treated between 2016 to 2022 at 19 sites in 13 countries (4 continents) were included. Of them, 773 (65.3%) underwent non-PUc IBBR and 410 (34.7%) PUc IBBR. Median age was 47 years (IQR 41-54) and median BMI was 24.4 kg/m2 (IQR 22-27.6). Median follow-up was 30.8 months (IQR 18.4-45.4) in the non-PUc group and 37.4 months (IQR 30-46.2) in the PUc group (p < 0.001).
Of 1183 patients, 863 (73%) had invasive ductal carcinoma and 654 (55.3%) hormone receptor–positive/HER2 negative disease, with a median Ki-67 of 25% (IQR 12-44%). Compared to PUc IBBR, use of non-PUc implants was associated with less frequent NSM (32.5% vs. 73.7%, p < 0.001), more frequent use of synthetic mesh (20.3% vs. 1%, p < 0.001) or acellular dermal matrix (20.3% vs. 1.2%, p < 0.001), and with one-stage IBBR (76.6% vs. 92.2%, p < 0.001).
Compared to PUc IBBR, use of non-PUc implants was associated with a higher rate of surgical revision due to CC (35.7% vs. 10.1%; hazard ratio [HR] 3.7, 95%CI 2.6-5.4, p < 0.001). The rate of any CC was also significantly higher in the non-PUc compared to the PUc group (58.7% vs. 33.3%; HR 1.9, 95%CI 1.5-2.4, p < 0.001).
The likelihood of major infection (OR 3.9, 95%CI 2.2-7.6,p < 0.001), implant loss (OR 11, 95%CI 6.7-19.1, p < 0.001), reoperation (OR 3.3, 95%CI 2.4-4.6, p < 0.001) and implant exposure (OR 7.9, 95%CI 2.6-35,p=0.001) was also higher in the non-PUc group.



Conclusions: This study showed a strong association between use of non-PUc vs. PUc implants and higher likelihood of surgical revision due to CC, as well as higher risk of complications, in the setting of PMRT. These findings may inform implant selection and reconstructive planning for irradiated patients.

Learning Objectives:

  • Upon completion, participants will be able to discuss the impact of type of implant after IBBR on capsular contracture in the setting of PMRT.
  • Upon completion, participants will be able to identify the impact of type of implant on short- and long-term complications after IBBR in the setting of PMRT.