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.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Lee K, Bang SI. Implant Surface Texture and Breast Cancer Recurrence—Reply. JAMA Surg. 2021;156(7):690–691. doi:10.1001/jamasurg.2021.0701
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.