Abstract PS2-01-01: Preoperative Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios as Predictors of Capsular Contracture after Nipple-Sparing Mastectomy with Implant-Based Breast Reconstruction

Abstract Background: Capsular contracture is a major complication following nipple-sparing mastectomy (NSM) with direct-to-implant (DTI) breast reconstruction. While inflammation is a known contributor to capsular contracture, the role of systemic inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) remains unclear. This study aimed to evaluate their predictive value for capsular contracture. Methods: We retrospectively reviewed 376 patients who underwent NSM with immediate DTI reconstruction. Patients were grouped by Baker’s classification into the non-contracture (grades 1–2) and the contracture (grades 3–4) groups. Clinical and pathological factors including preoperative NLR and PLR were analyzed. The optimal cut-off values for NLR and PLR were determined using receiver operating characteristic (ROC) curve analysis. Results: Among the 376 patients, 43 (11.4%) developed grade 3 or 4 capsular contracture during follow-up. The contracture group showed significantly higher rates of radiotherapy, chemotherapy, and elevated NLR/PLR. Multivariate analysis identified radiotherapy (OR 12.142, p