{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T02:31:12Z","timestamp":1792549872916,"version":"4.5.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":82,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Surg Onc"],"DOI":"10.1186\/s12957-026-04443-y","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T23:46:37Z","timestamp":1782949597000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Oncologic outcomes after poly-4-hydroxybutyrate scaffold in post-mastectomy breast reconstruction: a retrospective, multi-center cohort study"],"prefix":"10.1186","volume":"24","author":[{"given":"Haytham","family":"Gareer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Tchou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil M.","family":"Iyengar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9402-5086","authenticated-orcid":false,"given":"Nicol\u00e1s","family":"Tentoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Shelley","family":"Hwang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiya","family":"Movassaghi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"McCracken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Krugman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"4443_CR1","volume-title":"2022 Plastic Surgery Statistics Report","author":"American Society of Plastic Surgeons (ASPS)","year":"2023","unstructured":"American Society of Plastic Surgeons (ASPS). 2022 Plastic Surgery Statistics Report. Arlington Heights, IL: ASPS; 2023."},{"issue":"5","key":"4443_CR2","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1097\/SAP.0000000000004233","volume":"94","author":"M Diffley","year":"2025","unstructured":"Diffley M, Tang A, Sawar K, et al. Comparative Postoperative Complications of Acellular Dermal Matrix and Mesh Use in Prepectoral and Subpectoral One-Stage Direct to Implant Reconstruction: A Retrospective Cohort Study. Ann Plast Surg. 2025;94(5):521\u20137. https:\/\/doi.org\/10.1097\/SAP.0000000000004233.","journal-title":"Ann Plast Surg"},{"key":"4443_CR3","doi-asserted-by":"publisher","first-page":"S75","DOI":"10.1097\/PRS.0000000000009520","volume":"150","author":"S Sigalove","year":"2022","unstructured":"Sigalove S, O\u2019Rorke E, Maxwell GP, Gabriel A. Evaluation of the Safety of a GalaFLEX-AlloDerm Construct in Prepectoral Breast Reconstruction. Plast Reconstr Surg. 2022;150:S75\u201381. https:\/\/doi.org\/10.1097\/PRS.0000000000009520.","journal-title":"Plast Reconstr Surg"},{"key":"4443_CR4","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000002339","author":"AS Levy","year":"2020","unstructured":"Levy AS, Bernstein JL, Xia JJ, et al. Poly-4-Hydroxybutyric Acid Mesh Compares Favorably With Acellular Dermal Matrix in Tissue Expander\u2013Based Breast Reconstruction. Ann Plast Surg July. 2020. https:\/\/doi.org\/10.1097\/SAP.0000000000002339.","journal-title":"Ann Plast Surg July"},{"key":"4443_CR5","doi-asserted-by":"publisher","unstructured":"Bai J, Ferenz S, Fracol M, Kim JY. Revision Breast Reconstruction With Biologic or Synthetic Mesh: An Analysis of Postoperative Capsular Contracture Rates. Aesthetic Surg J Open forum. 2024;6. https:\/\/doi.org\/10.1093\/asjof\/ojae035.","DOI":"10.1093\/asjof\/ojae035"},{"issue":"3","key":"4443_CR6","doi-asserted-by":"publisher","first-page":"E7549","DOI":"10.1097\/GOX.0000000000007549","volume":"14","author":"TJ Sorenson","year":"2026","unstructured":"Sorenson TJ, Boyd CJ, Hemal K, Cohen O, Choi M, Karp N. Restoring Symmetry in Challenging Revision Breast Surgery: Outcomes of Pilot Study with Poly-4-Hydroxybutyrate Implant Construct. Plast Reconstr Surg Glob Open. 2026;14(3):E7549. https:\/\/doi.org\/10.1097\/GOX.0000000000007549.","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"11","key":"4443_CR7","doi-asserted-by":"publisher","first-page":"E7268","DOI":"10.1097\/GOX.0000000000007268","volume":"13","author":"TJ Sorenson","year":"2025","unstructured":"Sorenson TJ, Boyd CJ, Hemal K, et al. Outcome of Prepectoral Direct-to-Implant Breast Reconstruction With the Poly-4-hydroxybutyrate Wrap. Plast Reconstr Surg Glob Open. 2025;13(11):E7268. https:\/\/doi.org\/10.1097\/GOX.0000000000007268.","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"1","key":"4443_CR8","doi-asserted-by":"publisher","first-page":"19","DOI":"10.4321\/S0376-78922024000100008","volume":"50","author":"JJ RUIZ-TREVI\u00d1O","year":"2024","unstructured":"Ruiz-Trevi\u00f1o JJ. My experience with direct to implant breast reconstruction using GalaFLEX\u00ae mesh. An affordable alternative to acellular dermal matrix? Cir pl\u00e1st iberolatinoam. 2024;50(1):19\u201326. https:\/\/doi.org\/10.4321\/S0376-78922024000100008.","journal-title":"Cir pl\u00e1st iberolatinoam"},{"key":"4443_CR9","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000010914","author":"K Movassaghi","year":"2023","unstructured":"Movassaghi K, Gilson A, Stewart CN, Cusic J, Movassaghi A. Prepectoral Two Stage Implant-Based Breast Reconstruction with Poly-4-Hydroxybutyrate (P4HB) for Pocket Control without the use of Acellular Dermal Matrix (ADM): A 4-Year Review. Ophthalmic Plast Reconstr Surg July. 2023. https:\/\/doi.org\/10.1097\/PRS.0000000000010914.","journal-title":"Ophthalmic Plast Reconstr Surg July"},{"key":"4443_CR10","doi-asserted-by":"publisher","unstructured":"McCracken A, Heidt J, Eldridge E, et al. The Guardian Research Network: A Real-World Data Source for Pharmacoepidemiologic Research and Regulatory Applications. Pharmacoepidemiol Drug Saf. 2025;34(9). https:\/\/doi.org\/10.1002\/pds.70202.","DOI":"10.1002\/pds.70202"},{"key":"4443_CR11","doi-asserted-by":"publisher","first-page":"690658","DOI":"10.3389\/fonc.2021.690658","volume":"11","author":"F-L Qu","year":"2021","unstructured":"Qu F-L, Mao R, Liu Z-B, et al. Spatiotemporal Patterns of Loco-Regional Recurrence After Breast-Conserving Surgery. Front Oncol. 2021;11:690658. https:\/\/doi.org\/10.3389\/fonc.2021.690658.","journal-title":"Front Oncol"},{"key":"4443_CR12","doi-asserted-by":"publisher","unstructured":"Thai JN, Sodagari F, Colwell AS, et al. Multimodality Imaging of Postmastectomy Breast Reconstruction Techniques, Complications, and Tumor Recurrence. Radiographics. 2024;44(5). https:\/\/doi.org\/10.1148\/rg.230070.","DOI":"10.1148\/rg.230070"},{"key":"4443_CR13","doi-asserted-by":"publisher","first-page":"58","DOI":"10.25259\/JCIS_113_2021","volume":"11","author":"BE Adrada","year":"2021","unstructured":"Adrada BE, Karbasian N, Huang M, Rauch GM, Woodtichartpreecha P, Whitman G. Imaging Surveillance of the Reconstructed Breast in a Subset of Patients May Aid in Early Detection of Breast Cancer Recurrence. J Clin Imaging Sci. 2021;11:58. https:\/\/doi.org\/10.25259\/JCIS_113_2021.","journal-title":"J Clin Imaging Sci"},{"issue":"8","key":"4443_CR14","doi-asserted-by":"publisher","first-page":"E3060","DOI":"10.1097\/GOX.0000000000003060","volume":"8","author":"JM Marks","year":"2020","unstructured":"Marks JM, Farmer RL, Afifi AM. Current Trends in Prepectoral Breast Reconstruction: A Survey of American Society of Plastic Surgeons Members. Plast Reconstr Surg Glob Open. 2020;8(8):E3060. https:\/\/doi.org\/10.1097\/GOX.0000000000003060.","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"4443_CR15","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1016\/j.bjps.2025.02.041","volume":"104","author":"R Di Giuli","year":"2025","unstructured":"Di Giuli R, Cavallero MF, Ferrari C, et al. Two-stage prepectoral breast reconstruction: A comprehensive review and meta-analysis. J Plast Reconstr Aesthet Surg. 2025;104:388\u201397. https:\/\/doi.org\/10.1016\/j.bjps.2025.02.041.","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"7","key":"4443_CR16","doi-asserted-by":"publisher","first-page":"5659","DOI":"10.1007\/s00520-022-06919-5","volume":"30","author":"J Liu","year":"2022","unstructured":"Liu J, Zheng X, Lin S, Han H, Xu C. A systematic review and meta-analysis on the prepectoral single-stage breast reconstruction. Support Care Cancer. 2022;30(7):5659\u201368. https:\/\/doi.org\/10.1007\/s00520-022-06919-5.","journal-title":"Support Care Cancer"},{"issue":"19","key":"4443_CR17","doi-asserted-by":"publisher","first-page":"3449","DOI":"10.1002\/cncr.34393","volume":"128","author":"CA Bargon","year":"2022","unstructured":"Bargon CA, Young-Afat DA, Ikinci M, et al. Breast cancer recurrence after immediate and delayed postmastectomy breast reconstruction\u2014A systematic review and meta\u2010analysis. Cancer. 2022;128(19):3449\u201369. https:\/\/doi.org\/10.1002\/cncr.34393.","journal-title":"Cancer"},{"issue":"2","key":"4443_CR18","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1016\/j.ejso.2016.07.006","volume":"43","author":"W Zhang, Li","year":"2017","unstructured":"Zhang, Li W, et al. Comparison of immediate breast reconstruction after mastectomy and mastectomy alone for breast cancer: A meta-analysis. Eur J Surg Oncol. 2017;43(2):285\u201393. https:\/\/doi.org\/10.1016\/j.ejso.2016.07.006.","journal-title":"Eur J Surg Oncol"},{"key":"4443_CR19","doi-asserted-by":"publisher","first-page":"6","DOI":"10.21037\/abs-21-44","volume":"7","author":"LR H\u00f6lmich","year":"2023","unstructured":"H\u00f6lmich LR, Sayegh F, Salzberg CA. Immediate or delayed breast reconstruction: the aspects of timing, a narrative review. Annals breast Surg. 2023;7:6. https:\/\/doi.org\/10.21037\/abs-21-44.","journal-title":"Annals breast Surg"},{"key":"4443_CR20","doi-asserted-by":"publisher","unstructured":"Chao M, Woo K, Long D, Toameh D, Isaac KV. January. Breast Cancer Local Recurrence in Patients With and Without Post-Mastectomy Immediate Breast Reconstruction: Systematic Review and Meta-Analysis. Plast Surg (Oakv). 2025. https:\/\/doi.org\/10.1177\/22925503251363108","DOI":"10.1177\/22925503251363108"},{"issue":"1","key":"4443_CR21","doi-asserted-by":"publisher","first-page":"84","DOI":"10.4274\/balkanmedj.2017.0029","volume":"35","author":"E \u00d6zkurt","year":"2018","unstructured":"\u00d6zkurt E, T\u00fckenmez M, G\u00fcven E, et al. Favorable Outcome with Close Margins in Patients Undergoing Nipple\/Skin Sparing Mastectomy with Immediate Breast Reconstruction: 5-year Follow-up. Balkan Med J. 2018;35(1):84\u201392. https:\/\/doi.org\/10.4274\/balkanmedj.2017.0029.","journal-title":"Balkan Med J"},{"key":"4443_CR22","doi-asserted-by":"publisher","unstructured":"Wu S, Mo M, Wang Y et al. Local recurrence following mastectomy and autologous breast reconstruction: incidence, risk factors, and management. Onco Targets Ther 2016;Volume 9:6829\u201334. https:\/\/doi.org\/10.2147\/OTT.S109356","DOI":"10.2147\/OTT.S109356"},{"issue":"6","key":"4443_CR23","doi-asserted-by":"publisher","first-page":"2037","DOI":"10.21037\/gs-21-15","volume":"10","author":"JH Joo","year":"2021","unstructured":"Joo JH, Ki Y, Kim W, et al. Pattern of local recurrence after mastectomy and reconstruction in breast cancer patients: a systematic review. Gland Surg. 2021;10(6):2037\u201346. https:\/\/doi.org\/10.21037\/gs-21-15.","journal-title":"Gland Surg"},{"key":"4443_CR24","doi-asserted-by":"publisher","unstructured":"Elahi SF, Martin DP, Wan Y, et al. 4-Hydroxybutyrate (4HB) released from poly-4-hydroxybutyrate scaffolds does not impact hallmark phenotypes of cancer in malignant or non-malignant breast cells. Breast Cancer Res. 2026;28(1). https:\/\/doi.org\/10.1186\/s13058-026-02234-7.","DOI":"10.1186\/s13058-026-02234-7"},{"issue":"2","key":"4443_CR25","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1007\/s00238-021-01868-4","volume":"45","author":"D Casella","year":"2022","unstructured":"Casella D, Kaciulyte J, Resca L, et al. Looking beyond the prepectoral breast reconstruction experience: a systematic literature review on associated oncological safety and cancer recurrence incidence. Eur J Plast Surg. 2022;45(2):223\u201331. https:\/\/doi.org\/10.1007\/s00238-021-01868-4.","journal-title":"Eur J Plast Surg"}],"container-title":["World Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12957-026-04443-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12957-026-04443-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12957-026-04443-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:03:46Z","timestamp":1790078626000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12957-026-04443-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4443"],"URL":"https:\/\/doi.org\/10.1186\/s12957-026-04443-y","relation":{},"ISSN":["1477-7819"],"issn-type":[{"value":"1477-7819","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,2]]},"assertion":[{"value":"10 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This retrospective study used de-identified data curated by the Guardian Research Network (GRN) under established data-use agreements. As this research involves only unidentifiable and de-identified health information, it is not human subjects research and thus does not require IRB review. However, GRN has IRB oversight for \u201cThe Guardian Program\u2122: An Initiative to Enhance and Accelerate Access to Clinical Trials\u201d which no longer requires IRB continuing review under the revised common rule (effective 1-21-2019); however WCG IRB will continue responsibility for exercising administrative and regulatory oversight of the deidentified data held by GRN (IRB Tracking Number 20150789).","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable (no identifiable individual person\u2019s data are included).","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Disclosures for each author are as follows:\u2022 Julia Tchou: Consultant for BD related to the content of this manuscript.\u2022 Neil M. Iyengar: Institutional research support from the National Cancer Institute (R01CA241409), Breast Cancer Research Foundation, and American Institute for Cancer Research. Consulting fees from BD related to this manuscript. Consulting fees unrelated to this work from Pfizer, Novartis, Genentech\/Roche, AstraZeneca, Daichi-Sankyo, Gilead, Bayer, TerSera Therapeutics, Puma, and SynDevRx. Equity ownership unrelated to this work in Complement1 and The Bettering Company.\u2022 E. Shelley Hwang: Consultant for BD related to the content of this manuscript; consultant to AstraZeneca and Merck; advisor to Exai Bio and Havah Therapeutics.\u2022 Kiya Movassaghi: Consultancy roles with Allergan, Motiva, Tiger Aesthetics, and Integra (formerly an investor in SIA). No financial interests related to the content of this manuscript.\u2022 Andrea McCracken: No relevant or material financial interests related to the research in this manuscript.\u2022 Nicol\u00e1s Tentoni: No relevant or material financial interests related to the research in this manuscript.\u2022 Kimberly Krugman: Employee of BD and holds stock in BD.\u2022 Haytham Gareer: Employee of BD and holds stock in BD.This work was supported by BD, which funded data curation through the Guardian Research Network (GRN). BD employees (HG, KK) participated in study conception and manuscript drafting; however, analytic plans, variable definitions, and interpretation were directed and critically reviewed by non-BD academic authors (JT, NMI, ESH, KM, AM, NT), who had full access to curated dataset outputs and final authority on the decision to submit.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"377"}}