title: The BREASTrial Stage II: ADM Breast Reconstruction Outcomes from Definitive Reconstruction to 3 Months Postoperative.
abstract: BACKGROUND
  The Breast Reconstruction Evaluation of Acellular Dermal Matrix as a Sling Trial is a prospective randomized trial comparing outcomes of tissue expander breast reconstruction using either AlloDerm or DermaMatrix. The trial was divided into 3 outcome stages; this study reports stage II outcomes, which are those from the time of definitive reconstruction to 3 months postoperative.
  
  
  METHODS
  A randomized trial was conducted to compare complication rates between AlloDerm and DermaMatrix groups. The impact of matrix type, age, obesity, radiation therapy, chemotherapy, and reconstruction type on complications was analyzed with regression models.
  
  
  RESULTS
  Of the 128 patients (199 breasts) who were randomly assigned into the trial, 111 patients (173 breasts) were available for analysis in stage II. There was no difference in overall rates of complications (15.4% vs 18.3%,P= 0.8) or implant loss (2.2% vs 3.7%,P= 0.5) between the AlloDerm and DermaMatrix groups, respectively. Obesity was the only significant predictor of complications on regression analysis (odds ratio, 4.31,P= 0.007). Matrix type, age, radiation therapy, chemotherapy, or reconstruction type had no impact on the incidence/severity of complications.
  
  
  CONCLUSIONS
  Acellular dermal matrix (ADM) will likely continue to have a role in breast reconstructive surgery; however, caution should be taken when using ADM because of relatively high complication rates, especially in obese patients. The particular ADM product should be selected based on individual surgeon preference, experience, and success rates. These data and forthcoming long-term outcomes from the Breast Reconstruction Evaluation of Acellular Dermal Matrix as a Sling Trial will enable surgeons to carefully weigh the risks and benefits of ADM use in breast reconstruction.
authors.affiliation: The Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, Ill.; Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah; Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah; Department of Surgery, University of Arizona, Tucson, Ariz.; and Division of Plastic and Reconstructive Surgery, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Shaun D
authors.initials: SD
authors.lastname: Mendenhall
authors.affiliation: The Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, Ill.; Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah; Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah; Department of Surgery, University of Arizona, Tucson, Ariz.; and Division of Plastic and Reconstructive Surgery, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Layla A
authors.initials: LA
authors.lastname: Anderson
authors.affiliation: The Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, Ill.; Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah; Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah; Department of Surgery, University of Arizona, Tucson, Ariz.; and Division of Plastic and Reconstructive Surgery, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Jian
authors.initials: J
authors.lastname: Ying
authors.affiliation: The Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, Ill.; Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah; Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah; Department of Surgery, University of Arizona, Tucson, Ariz.; and Division of Plastic and Reconstructive Surgery, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Boucher
authors.affiliation: The Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, Ill.; Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah; Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah; Department of Surgery, University of Arizona, Tucson, Ariz.; and Division of Plastic and Reconstructive Surgery, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Leigh A
authors.initials: LA
authors.lastname: Neumayer
authors.affiliation: The Institute for Plastic Surgery, Southern Illinois University School of Medicine, Springfield, Ill.; Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah; Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah; Department of Surgery, University of Arizona, Tucson, Ariz.; and Division of Plastic and Reconstructive Surgery, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Jayant P
authors.initials: JP
authors.lastname: Agarwal