Kerstin Wimmer MD; 2026 EBCC: Polyurethane-Coated Implants Reduce Capsular Contracture Risk after Mastectomy with Radiotherapy for Breast Cancer

Polyurethane-Coated Implants Reduce Capsular Contracture Risk after Mastectomy with Radiotherapy for Breast Cancer

An interview with:

Kerstin Wimmer MD, Medical University of Vienna, Department of General Surgery, Vienna, Austria; Post-Doctoral Researcher, Karolinska Institute, Stockholm, Sweden

BARCELONA, Spain—Women who had mastectomy with immediate pre-pectoral breast reconstruction followed by radiotherapy had less risk of capsular contracture when polyurethane-coated breast implants were used rather than un-coated implants. This finding from the OPBC-09 PRExRT study was reported at the 2026 European Breast Cancer Conference by Kerstin Wimmer MD, from the Medical University of Vienna’s Department of General Surgery in Vienna, Austria, who is currently doing post-doctoral researcher at the Karolinska Institute in Stockholm, Sweden. After her presentation, she discussed the findings with Audio Journal of Oncology correspondent Peter Goodwin:

AUDIO JOURNAL OF ONCOLOGY: Kerstin Wimmer MD

IN: [GOODWIN]”Peter Goodwin here, reporting……

OUT: on Oncology, I’m Peter Goodwin

2026 EBCC: Barcelona

Abstract no: 2

The impact of polyurethane coated implants on the risk of capsular contracture after immediate prepectoral breast reconstruction in the setting of postmastectomy radiotherapy: the OPBC-09 PRExRT study

1. Wimmer1, R. Kiblawi2, F. Fitzal3, C. Kohl4, L. Stenman Skarsgård5, G. Franceschini6, D. Virzi7,
2. Molska8, J.M. Broyles9, A. Agrawal10, G. Montagna11, M. Rivas Ibarra12, M. Banys-Paluchowski13, M. Knauer14, E. Gonzales15, J. Letzkus Berrios16, G. Karadeniz Çakmak17, D. Vorburger18,
3. Ferrucci19, W.P. Weber20

OPBC study group

1Medical University of Vienna, Department of General Surgery, Vienna, Austria

2University Hospital Basel, Department of Gynaecology & Obstetrics, Basel, Austria

3Hanusch Hospital, Department of Breast Reconstruction, Vienna, Austria

4Kliniken Essen-Mitte, Interdisciplinary Breast Center, Essen, Germany

5Oslo University Hospital, Department of Plastic and Reconstructive Surgery, Oslo, Norway

6Fondazione Policlinico Universitario Agostino Gemelli IRCCS,

Department of Science and Health of Women- Children and Public Health, Rome, Italy

7Humanitas Istituto Clinico Catanese, Plastic Surgery Unit, Catania, Italy

8University Hospital Zielona Góra, Clinical Department of General and Oncological Surgery, Zielona Góra, Poland

9Dana Farber/Brigham Cancer Center, Division of Breast Surgery- Brigham and Women’s Hospital, Boston, USA

10Cambridge University Hospitals, Department of Breast Surgery, Cambridge, United Kingdom

11Memorial Sloan Kettering Cancer Center, Breast Service- Department of Surgery, New York, USA

12Arturo López Pérez Foundation, Department of Breast Surgery, Santiago, Chile

13University Hospital Schleswig-Holstein- Campus Lübeck, Department of Gynecology and Obstetrics, Lübeck, Germany

14Tumor and Breast Center Eastern Switzerland, Tumor and Breast Center, St.Gallen, Switzerland 15Sanatorio Modelo Quilmes, Department of Senology, Buenos Aires, Argentina

16San Borja Arriarán Clinical Hospital-Clínica MEDS, Breast Surgical Unit, Santiago, Chile 17Zonguldak Bülent Ecevit University Faculty of Medicine, Department of General Surgery, Zonguldak, Turkey

18University Hospital Zurich, Breast Cancer Center- Department of Gynecology, Zurich, Switzerland 19IRCCS, Veneto Institute of Oncology, Padova, Italy

20University Hospital Basel, Breast Clinic, Basel, Switzerland

Introduction

Patients with breast cancer undergoing mastectomy with implant-based breast reconstruction (IBBR), who are at high risk of locoregional recurrence, often require postmastectomy radiotherapy (PMRT), which increases the risk of capsular contracture (CC). The present study assessed the association between use of polyurethane coated (PUc) versus non-PUc implants and the need for surgical revision due to CC in the setting of PMRT.

Material and methods

This international multicenter retrospective real-world study included patients with breast cancer who underwent nipple- (NSM) or skin-sparing mastectomy (SSM) with prepectoral IBBR with or without PUc implants followed by PMRT. Primary endpoint was surgical revision due to CC and was analyzed using Cox regression models.

Results

1183 women treated between 2016 to 2022 at 19 sites in 13 countries (4 continents) were included. Of them, 773 (65.3%) underwent non-PUc IBBR and 410 (34.7%) PUc IBBR. Median age was 47 years (IQR 41-54) and median BMI was 24.4 kg/m2 (IQR 22-

27.6). Median follow-up was 30.8 months (IQR 18.4-45.4) in the non-PUc group and 37.4 months (IQR 30-46.2) in the PUc group (p<0.001).

Of 1183 patients, 863 (73%) had invasive ductal carcinoma and 654 (55.3%) hormone receptor–positive/HER2 negative disease, with a median Ki-67 of 25% (IQR 12-44%). Compared to PUc IBBR, use of non-PUc implants was associated with less frequent NSM (32.5% vs. 73.7%, p <0.001), more frequent use of synthetic mesh (20.3% vs. 1%, p <0.001) or acellular dermal matrix (20.3% vs. 1.2%, p <0.001), and with one-stage IBBR (76.6% vs. 92.2%, p <0.001).

Compared to PUc IBBR, use of non-PUc implants was associated with a higher rate of surgical revision due to CC (35.7% vs. 10.1%; hazard ratio [HR] 3.7, 95%CI 2.6-5.4, p <0.001). The rate of any CC was also significantly higher in the non-PUc compared to the PUc group (58.7% vs. 33.3%; HR 1.9, 95%CI 1.5-2.4, p <0.001).

The likelihood of major infection (OR 3.9, 95%CI 2.2-7.6, p<0.001), implant loss (OR 11, 95%CI 6.7-19.1, p<0.001), reoperation (OR 3.3, 95%CI 2.4-4.6, p <0.001) and implant exposure (OR 7.9, 95%CI 2.6-35,p=0.001) was also higher in the non-PUc group.

Conclusions

This study showed a strong association between use of non-PUc vs. PUc implants and higher likelihood of surgical revision due to CC, as well as higher risk of complications, in the setting of PMRT. These findings may inform implant selection and reconstructive planning for irradiated patients.

Kerstin Wimmer EBCC 2026 A. J. Oncology, March 31, 2026