Trial Information

Effect of Radiation on Tissue for Delayed Breast Reconstruction

In the setting of post-mastectomy radiation therapy delayed autologous reconstruction,
favored by many attempts to avoid complications encountered with radiating the immediately
reconstructed breast. The timing of delayed reconstruction is however not known. The goal of
this proposal is to study the gross, structural and vascular changes in radiated mastectomy
skin in addition to possible structural and flow changes of the underlying internal mammary
vessels over time. We plan to use these objective findings as a basis for determining an
ideal time frame for delayed autologous breast reconstruction.

Sequential mastectomy skin specimens will be obtained from 20 patients undergoing
post-mastectomy radiation therapy over a 24 month period and these specimens will be
evaluated histologically. These same patients will also undergo serial examinations and
photographic documentation of gross skin changes. Skin perfusion will be assessed by laser
Doppler imaging and internal mammary vessel structure, and flow characteristics will be
assessed by color Doppler sonography.

Based on these studies, we will elucidate short and long term changes in radiated breast
skin, showing inflammatory, structural and perfusion patterns that can be correlated with
optimal conditions for reconstruction. This has the potential to dramatically change
practice patterns of delayed reconstruction for many reconstructive surgeons and more
importantly restore what patients loose with mastectomy in a consistent, timely fashion.
There is also potential for improved outcomes of delayed breast reconstruction by decreasing
the number of reconstructions performed too soon after completion of radiation.