The Impact of Radiation and Its Timing on Donor Internal Mammary Vessel Histopathology at the Time of Autologous Microvascular Breast Reconstruction
| Autor: | Imran Zoberi, Caroline Min, Aaron B. Mull, Terence M. Myckatyn, Ali A Qureshi, Elizabeth B. Odom, Daniel A. Hunter, Yuan James Rao |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Microsurgery medicine.medical_specialty Pathology Time Factors Mammaplasty medicine.medical_treatment Clinical Decision-Making Breast Neoplasms 030230 surgery 03 medical and health sciences 0302 clinical medicine Biopsy Humans Medicine Breast Mammary Arteries biology medicine.diagnostic_test business.industry Macrophages Actins Elastin Radiation therapy Treatment Outcome 030220 oncology & carcinogenesis biology.protein Female Surgery Histopathology Collagen Thickening business Free flap surgery Breast reconstruction Nuclear medicine |
| Zdroj: | Journal of Reconstructive Microsurgery. 33:509-517 |
| ISSN: | 1098-8947 0743-684X |
| DOI: | 10.1055/s-0037-1602741 |
| Popis: | Background We evaluate the impact of radiation and its early versus late effects on internal mammary vessel histomorphometry and implications for autologous breast reconstruction. Methods Patients received no radiation or radiation within the previous 6 weeks (early) or at least 6 months prior to biopsy (late) of the internal mammary vessels during free flap surgery. Clinical outcomes, and vessel measurements and markers for macrophages, smooth muscle actin (SM-ACTIN), elastin, and collagen were analyzed. Results We analyzed 36 internal mammary arteries (IMAs) and veins (IMV) in 22 patients. Six had no radiation, 12 had radiation less than 6 weeks, and 18 had radiation more than 6 months ago. Demographics, surgical variables, and cardiovascular comorbidity did not differ between groups. Macrophage counts were higher in patients who had radiation (p Conclusion Higher macrophage counts but less intimal thickening of the IMA differentiates donor vessels utilized within 6 weeks of radiotherapy and those performed after 6 months or more. Although the timing of reconstruction is based on several other factors, histologic parameters support reconstruction within 6 weeks of radiation therapy. |
| Databáze: | OpenAIRE |
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