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Background <p>The suture scaffold technique (SST) is a simple oncoplastic method used during breast-conserving surgery (BCS) to preserve breast contour by bridging the resection cavity. Although favorable cosmetic outcomes have been reported, its healing process and complication profile remain insufficiently evaluated.</p> Methods <p>This retrospective single-institution study included patients who underwent BCS with oncoplastic procedures between 2017 and 2022. Postoperative healing after SST was assessed by short-term ultrasonography, mid-term histopathology, and long-term ultrasonographic and elastographic evaluations, with the breast glandular flap technique (BGFT) as comparator. Complications were assessed at approximately one month, classified by the Clavien–Dindo system, and compared among SST, BGFT, and no oncoplastic technique (NOT). Risk factors were analyzed using logistic regression adjusted for clinical covariates.</p> Results <p>Ultrasonography on postoperative day 8 after SST revealed serous fluid retention and fibrin-like fibers around scaffold sutures with connective tissue ingrowth. Histopathology of re-excised specimens at 1–4&#xa0;months showed fibrin deposition and granulation tissue, which matured into fibrotic scar tissue. Long-term ultrasonography (mean follow-up 4.4&#xa0;years) demonstrated slightly more evident scar formation in the SST group compared with BGFT, with cysts that mostly resolved spontaneously. Shear-wave elastography showed no significant difference in scar stiffness (1.81 ± 0.56 vs. 1.49 ± 0.48&#xa0;m/s; p = 0.065). Among 643 patients (421 SST, 134 BGFT, 88 NOT), 11 clinically significant complications (1.7%) were observed, including 7 grade 2 infections requiring antibiotics and 4 grade 3 events requiring intervention. Multivariate analysis found no significant intergroup differences in complication rates.</p> Conclusions <p>SST is a safe and technically simple oncoplastic option that preserves cosmetic outcomes without increasing complications. It may serve as a practical alternative to conventional oncoplastic techniques in BCS.</p>

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Postoperative course and safety profile of the suture scaffold technique in breast-conserving surgery: a single-institution observational study

  • 期刊论文

  • 发表日期：

    2025年12月29日

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  • Reiko Mitsueda,
  • Yasuyo Ohi,
  • Yukari Mochitomi,
  • Rie Takaki,
  • Megumi Furukawa,
  • Akiko Arimura,
  • Yoshitaka Fujiki,
  • Naomi Gondo,
  • Junko Kawano,
  • Shuichi Kanemitsu,
  • Megumi Teraoka,
  • Yoshiaki Rai,
  • Sakurako Yanase,
  • Hayahito Sakai,
  • Sugako Nomoto,
  • Yoshiaki Sagara,
  • Shinji Ohno,
  • Yasuaki Sagara

摘要

Background

The suture scaffold technique (SST) is a simple oncoplastic method used during breast-conserving surgery (BCS) to preserve breast contour by bridging the resection cavity. Although favorable cosmetic outcomes have been reported, its healing process and complication profile remain insufficiently evaluated.

Methods

This retrospective single-institution study included patients who underwent BCS with oncoplastic procedures between 2017 and 2022. Postoperative healing after SST was assessed by short-term ultrasonography, mid-term histopathology, and long-term ultrasonographic and elastographic evaluations, with the breast glandular flap technique (BGFT) as comparator. Complications were assessed at approximately one month, classified by the Clavien–Dindo system, and compared among SST, BGFT, and no oncoplastic technique (NOT). Risk factors were analyzed using logistic regression adjusted for clinical covariates.

Results

Ultrasonography on postoperative day 8 after SST revealed serous fluid retention and fibrin-like fibers around scaffold sutures with connective tissue ingrowth. Histopathology of re-excised specimens at 1–4 months showed fibrin deposition and granulation tissue, which matured into fibrotic scar tissue. Long-term ultrasonography (mean follow-up 4.4 years) demonstrated slightly more evident scar formation in the SST group compared with BGFT, with cysts that mostly resolved spontaneously. Shear-wave elastography showed no significant difference in scar stiffness (1.81 ± 0.56 vs. 1.49 ± 0.48 m/s; p = 0.065). Among 643 patients (421 SST, 134 BGFT, 88 NOT), 11 clinically significant complications (1.7%) were observed, including 7 grade 2 infections requiring antibiotics and 4 grade 3 events requiring intervention. Multivariate analysis found no significant intergroup differences in complication rates.

Conclusions

SST is a safe and technically simple oncoplastic option that preserves cosmetic outcomes without increasing complications. It may serve as a practical alternative to conventional oncoplastic techniques in BCS.