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The use of acellular dermal matrix in immediate two-stage prosthetic breast reconstruction provides protection from postmastectomy radiation therapy: a clinicopathologic perspective

Authors
 Tae Hwan Park  ;  Soon Won Chung  ;  Seung Yong Song  ;  Dae Hyun Lew  ;  Tai Suk Roh  ;  Dong Won Lee 
Citation
 Journal of Materials Science-Materials in Medicine, Vol.29(3) : 27, 2018 
Journal Title
 Journal of Materials Science-Materials in Medicine 
ISSN
 0957-4530 
Issue Date
2018
Abstract
Although there is ample evidence showing that radiation therapy increases the risk of complications of breast reconstruction, the efficacy of human acellular dermal matrix (CGCryoDerm(R)) in immediate tissue expander breast reconstruction in the setting of postmastectomy radiation therapy has not been fully elucidated. In this study, we report our institutional experience with pertinent refined surgical technique, and determine whether acellular dermal matrices have a protective effect in this increasingly prevalent clinical setting. Twenty-six patients who underwent immediate two-stage breast reconstruction in the setting of postmastectomy radiation therapy with at least 2 years of follow-up were retrieved. Fifteen patents were reconstructed with ADM, whereas 11 patients were reconstructed without ADM. The occurrence of complications was assessed according to the reconstruction type (with ADM vs without ADM). Furthermore, in patients reconstructed with ADM (n = 15), immunohistochemistry was performed to analyze the breast capsule with ADM compared with that without ADM in the same patient, according to the expression of alpha-smooth muscle actin (alpha-SMA). The occurrence of complications was significantly associated with the reconstruction type (with ADM vs. without ADM, p = 0.015). On the basis of the results of alpha-SMA staining, alpha-SMA+ myofibroblasts were relatively highly expressed throughout the breast capsule without ADM. On the contrary, alpha-SMA+ myofibroblasts present at the breast capsule adjacent to the ADM were scarce and irregularly scattered. Use of an acellular dermal matrix may be recommended to patients who are concerned about complications after immediate two-stage breast reconstruction in the setting of postmastectomy radiation therapy.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162273
Full Text
https://link.springer.com/article/10.1007%2Fs10856-018-6036-6
DOI
10.1007/s10856-018-6036-6
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실)
Yonsei Authors
노태석(Roh, Tai Suk) ORCID logo https://orcid.org/0000-0001-8681-159X
송승용(Song, Seung Yong) ORCID logo https://orcid.org/0000-0002-3145-7463
유대현(Lew, Dae Hyun)
이동원(Lee, Dong Won) ORCID logo https://orcid.org/0000-0003-0046-3139
정순원(Chung, Soon Won)
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