Ann Plast Reconstr Surg | Volume 3, Issue 2 | Research Article | Open Access

A Novel Method for Marking the Tumor Bed Margins in Partial Breast Reconstruction

John Harman^1*, Stan Govender¹, John Simpson², Benji Benjamin² and Gail Lebovic³

¹St. Mark’s Women’s Health Centre, New Zealand ²Auckland Radiation Oncology, New Zealand ³School of Oncoplastic Surgery, Texas, USA

^*Correspondance to: John Harman 

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Abstract

Background: In New Zealand, Oncoplastic Surgery (OPS) is common, but partial breast reconstruction presents challenges for radiation targeting. Tissue rearrangement creates ambiguity when targeting the tumor bed with resultant overestimation of treatment volumes. Thus, adoptions of advanced methods of radiation have been hindered. This pilot study describes use of a novel 3-dimensional implant that provides scaffolding for tissue in growth during partial breast reconstruction and delineates the tumor bed more precisely to assist radiation planning and mammographic surveillance. Methods: Following informed consent, 15 women were implanted with the 3-dimensional bio-absorbable implant. The device was sutured to the tumor bed during lumpectomy, and tissue flaps were mobilized and attached to the implant. Visualization of the marker and radiation treatment volumes were recorded and compared. Results: The implant provided volume replacement and helped to maintain breast contour. Cosmetic outcomes were excellent; no device-related or radiation complications occurred. One patient had a post-operative hematoma that resolved after percutaneous drainage; there were no post-operative infections. Three year follow up shows no tumor recurrences, and no untoward effects. When compared to conventional radiation targeting, use of the implant showed a >50% reduction in treatment volume was possible in some cases. Three year mammograms show no significant artifact, normal tissue in-growth and minimal fibrosis. Conclusion: This study describes a method of oncoplastic breast reconstruction using an implantable device that marks the site of tumor excision and provides for volume replacement with tissue in-growth. Patients tolerated it well, and radiation planning, positioning and treatment were facilitated.

Keywords:

Breast reconstruction; New Zealand; BCT; PM; RT

Citation:

Harman J, Govender S, Simpson J, Benjamin B, Lebovic G. A Novel Method for Marking the Tumor Bed Margins in Partial Breast Reconstruction. Ann Plast Reconstr Surg. 2019;3(2):1031..