Using own tissue in breast reconstruction less risky

Women who use their own tissue in breast reconstruction have fewer post-op complications then those who receive implants, Kiwi researchers have found. Photo / File

Women who use their own tissue in breast reconstruction have fewer post-op complications then those who receive implants, Kiwi researchers have found.

In breast cancer patients here and around the world, breast reconstruction is commonly undertaken following mastectomy.

A new study, just published in the New Zealand Medical Journal, looked at patients who were undergoing external beam radiotherapy, or XRT, who had received implant-based breast reconstruction (IBBR), and found these patients had a greater complication rates post-surgery.

It analysed IBBR outcomes at Counties Manukau District Health Board between January 2012 and December 2013, over which 77 procedures were performed in 53 patients.

In 2012, 11 patients underwent radiotherapy before or after their surgery, compared with five in 2013.

The study found radiotherapy was strongly linked with higher reconstructive failure rates, while pre-operative XRT was associated with more complications overall, including infections, wound healing problems and fluid collections, or seroma.

Over the two years, the number of IBBRs with any complication fell from 16 to 11 – or from 43.2 per cent to 27.5 per cent - while reconstructive failure fell from six to four, or 16.2 per cent to 10 per cent.

"Our study has found that the complication rate in patients having implant-based breast reconstruction after radiotherapy for breast cancer treatment is very high," said study leader Dr Michelle Locke, of the University of Auckland's School of Medicine.

"We now encourage patients to use their own tissue, for example, from their abdomen, to reconstruct their breasts if they have had radiotherapy.

"We have shown a lower complication rate in women who use their own tissue rather than implants for reconstruction following radiotherapy."

The researchers advised their patients with a history of previous XRT or a high likelihood of requiring post-operative XRT of the high risk of complications of IBBR.

These patients are encouraged to favour autologous reconstructive options instead, where the patient's own tissue was used.

"We are always striving to give patients the best possible results with the fewest complications," Locke said.

"That way we try to alleviate any further stress on our patients"

The research team also included Dr William LE Malins of Newcastle University Medical School in the UK, Jia Le See of Auckland University, and Dr John Kenealy of Counties Manukau DHB.

Meanwhile, the Environmental Protection Authority (EPA) has just approved a potentially life-saving treatment for melanoma that involves genetically modified organisms, or GMOs.

Telomelysin, a genetically modified virus, will be used as part of a clinical trial of patients with advanced and inoperable melanoma.

"It is derived from a common human virus, that nearly all people are immune to from around the age of two," said Dr Fiona Thomson-Carter, EPA's general manager of hazardous substances and new organisms.

"Once directly injected into the tumour, it replicates in cancer cells, targeting them for destruction."

The approval, under the Hazardous Substances and New Organisms Act, has been granted to applicant Oncolys BioPharma Incorporated, which will use the virus in clinical trials to explore its effectiveness and any side-effects.

"In granting the approval, the EPA has set strict controls that will protect people and the environment to enable the clinical trial to go ahead," Thomson-Carter said.

Oncolys BioPharma Inc has a five-year timeframe in which to begin the trial.