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Comment & Response
April 14, 2021

Implant Surface Texture and Breast Cancer Recurrence—Reply

Author Affiliations
  • 1Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
JAMA Surg. 2021;156(7):690-691. doi:10.1001/jamasurg.2021.0701

In Reply We deeply appreciate valuable comments provided by de Andrade Urban et al, Bijlard and Mureau, and Maarse and Teunis in response to our study.1 Thankfully, they addressed several critical points that had not been fully considered during preparation of our original study.

The first one is a heterogeneity of reconstructive operation-related variables between smooth and textured implant groups, especially in terms of the type of tissue expander and the use of acellular dermal matrix (ADM). In our study,1 all tissue expanders used had textured surface, which were categorized into microtextured (Siltex) and macrotextured (Biocell). The type of tissue expander did not differ significantly between the groups (P =.44). Meanwhile, the rate of ADM use was different, showing a significantly higher rate in the textured implant group (78.9% vs 39.4%; P <.001). Because this imbalanced distribution of ADM use between the groups might affect outcomes, we included the variable in the following new analyses.

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