Increased mesh exposure complications in breast cancer survivors taking antiestrogen therapy.

Objectives: There is no current data investigating the relationship between mesh-exposure complications following TVT surgery and anti-estrogen therapy. We sought to determine if there are increased mesh-exposure complications between a breast cancer population versus benign population particularly in conjunction with hormone suppression therapy (HS).

Methods: A retrospective chart review was performed on patients with a history of breast cancer undergoing TVT surgery at our institution between 2013 and 2021. A group of patients who underwent TVT surgery without a history of cancer served as our control. Univariate and multivariate logistic regression analyses were performed to identify predictors of mesh exposure complications.

Results: 117 patients were identified with previously treated breast cancer who underwent TVT surgery. We identified 282 benign patients who underwent TVT surgery during the same period. Baseline characteristics across all groups were similar (Table 1).

28 patients (7.1%) experienced mesh exposure. This occurred at a higher rate in our cancer (16.2%) versus benign population (3.4%) (Figure 1). Women with breast cancer on HS had a higher rate of mesh exposure complications compared to those not on HS [15/58 (25.9%) versus 4/59 (6.8%); p=0.005]. The highest rate of mesh exposure complications occurred in the cohort taking estrogen receptor modulators [SERM 10/34 (29.4%) versus aromatase inhibitors 5/24 (20.8%) versus no HS [4/59 (6.8%); p=0.014] (Figure 1). On multivariate analysis, HS use [OR:1.57, p=0.007] and diabetes mellitus [OR:4.53, p=0.018] were associated with increased TVT-related complications.

Conclusions: Women with breast cancer had a higher rate of mesh exposure complications from TVT surgery compared to women without cancer, particularly those taking antiestrogenic therapy.