BACKGROUND: Immediate expander-based breast reconstruction after mastectomy is a prevalent option for many women with breast cancer. When coupled with adjuvant radiation therapy, however, radiation-induced skin and soft-tissue injury diminish the success of this reconstructive technique. The authors hypothesize that prophylactic administration of the cytoprotectant amifostine will reduce soft-tissue complications from irradiation, aiding expander-based reconstruction. METHODS: Sprague-Dawley rats were divided into two groups: operative expander placement (expander group) and operative sham (sham group). Expander specimens received a sublatissimus tissue expander with a 15-cc fill volume; shams underwent identical procedures without expanders. Experimental groups were further divided into control specimens receiving no further intervention, radiation therapy-only specimens receiving human-equivalent irradiation, and amifostine plus radiation therapy specimens receiving both amifostine and human-equivalent irradiation. After a 45-day recovery period, animals were evaluated grossly and with ImageJ analysis for skin and soft-tissue complications. RESULTS: None of the control, radiation therapy-alone, or amifostine plus radiation therapy sham specimens showed skin and soft-tissue complications. For expander animals, significantly fewer amifostine plus radiation therapy specimens [four of 13 (30 percent)] demonstrated skin and soft-tissue complications compared with radiation therapy-alone specimens [nine of 13 (69 percent); p = 0.041]. ImageJ evaluation of expander specimens demonstrated a significant increase in skin and soft-tissue necrosis for radiation therapy-alone specimens (12.94 percent) compared with animals receiving amifostine plus radiation therapy (6.96 percent) (p = 0.019). CONCLUSIONS: Amifostine pretreatment significantly reduced skin and soft-tissue complications. These findings demonstrate that amifostine prophylaxis provides protection against radiation-induced skin and soft-tissue injury in a murine model of expander-based breast reconstruction.
BACKGROUND: Immediate expander-based breast reconstruction after mastectomy is a prevalent option for many women with breast cancer. When coupled with adjuvant radiation therapy, however, radiation-induced skin and soft-tissue injury diminish the success of this reconstructive technique. The authors hypothesize that prophylactic administration of the cytoprotectant amifostine will reduce soft-tissue complications from irradiation, aiding expander-based reconstruction. METHODS:Sprague-Dawley rats were divided into two groups: operative expander placement (expander group) and operative sham (sham group). Expander specimens received a sublatissimus tissue expander with a 15-cc fill volume; shams underwent identical procedures without expanders. Experimental groups were further divided into control specimens receiving no further intervention, radiation therapy-only specimens receiving human-equivalent irradiation, and amifostine plus radiation therapy specimens receiving both amifostine and human-equivalent irradiation. After a 45-day recovery period, animals were evaluated grossly and with ImageJ analysis for skin and soft-tissue complications. RESULTS: None of the control, radiation therapy-alone, or amifostine plus radiation therapy sham specimens showed skin and soft-tissue complications. For expander animals, significantly fewer amifostine plus radiation therapy specimens [four of 13 (30 percent)] demonstrated skin and soft-tissue complications compared with radiation therapy-alone specimens [nine of 13 (69 percent); p = 0.041]. ImageJ evaluation of expander specimens demonstrated a significant increase in skin and soft-tissue necrosis for radiation therapy-alone specimens (12.94 percent) compared with animals receiving amifostine plus radiation therapy (6.96 percent) (p = 0.019). CONCLUSIONS:Amifostine pretreatment significantly reduced skin and soft-tissue complications. These findings demonstrate that amifostine prophylaxis provides protection against radiation-induced skin and soft-tissue injury in a murine model of expander-based breast reconstruction.
Authors: Alicia E Snider; Jeremy V Lynn; Kevin M Urlaub; Alexis Donneys; Yekaterina Polyatskaya; Noah S Nelson; Russell E Ettinger; Geoffrey C Gurtner; Mark M Banaszak Holl; Steven R Buchman Journal: Ann Plast Surg Date: 2018-11 Impact factor: 1.539
Authors: Jeremy V Lynn; Kevin M Urlaub; Kavitha Ranganathan; Alexis Donneys; Noah S Nelson; Chitra Subramanian; Mark S Cohen; Steven R Buchman Journal: Plast Reconstr Surg Date: 2019-06 Impact factor: 4.730
Authors: Jose J Rodriguez; Theodore Kung; Yao Wang; Noah S Nelson; Yekaterina Polyatskaya; Sagar S Deshpande; Alexander R Zheutlin; Alexis Donneys; Steven R Buchman; Adeyiza O Momoh Journal: Ann Plast Surg Date: 2016-05 Impact factor: 1.539
Authors: Alexandra O Luby; Chitra Subramanian; Lauren K Buchman; Jeremy V Lynn; Kevin M Urlaub; Noah S Nelson; Alexis Donneys; Mark S Cohen; Steven R Buchman Journal: Ann Plast Surg Date: 2020-10 Impact factor: 1.763
Authors: Alexandra O Luby; Alicia E Snider; Gurjit S Mandair; Kevin M Urlaub; Jeremy V Lynn; Noah S Nelson; Alexis Donneys; Russell E Ettinger; Geoffrey C Gurtner; David Kohn; Steven R Buchman Journal: Ann Plast Surg Date: 2020-11 Impact factor: 1.763
Authors: Paridhi Gupta; Manoshi Gayen; Joan T Smith; Elena K Gaidamakova; Vera Y Matrosova; Olga Grichenko; Barbara Knollmann-Ritschel; Michael J Daly; Juliann G Kiang; Radha K Maheshwari Journal: PLoS One Date: 2016-08-08 Impact factor: 3.240