Histological comparison between irradiated and non-irradiated breasts in breast reconstruction

Introduction: The treatment of breast cancer includes not only curative therapies but also breast reconstruction. Radiotherapy, an adjuvant strategy, provides favorable outcomes by reducing the rate of recurrence of the disease. This study aimed to compare histological differences between irradiated...

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Main Authors: Alberto Benedik, Ronan Caputi Silva Dias, Amanda Costa Campos, Carolina Oliveira Paranagua Castro, Marcela Caetano Cammarota, José Carlos Daher
Format: Article
Language:English
Published: Sociedade Brasileira de Cirurgia Plástica 2020-03-01
Series:Revista Brasileira de Cirurgia Plástica
Subjects:
Online Access:http://www.rbcp.org.br/export-pdf/2696/en_v35n1a08.pdf
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author Alberto Benedik
Ronan Caputi Silva Dias
Amanda Costa Campos
Carolina Oliveira Paranagua Castro
Marcela Caetano Cammarota
José Carlos Daher
author_facet Alberto Benedik
Ronan Caputi Silva Dias
Amanda Costa Campos
Carolina Oliveira Paranagua Castro
Marcela Caetano Cammarota
José Carlos Daher
author_sort Alberto Benedik
collection DOAJ
description Introduction: The treatment of breast cancer includes not only curative therapies but also breast reconstruction. Radiotherapy, an adjuvant strategy, provides favorable outcomes by reducing the rate of recurrence of the disease. This study aimed to compare histological differences between irradiated and non-irradiated breasts in the same patient. Methods: This is a prospective cohort study of patients undergoing breast reconstruction with prosthesis or expander under pectoralis major muscle flap that compared histological skin patterns, subcutaneous cell tissue, pectoralis major muscle, and implant capsule of irradiated and non-irradiated breasts in paired samples of the same patient. All patients included in this study were irradiated in only one breast. The results of the anatomopathological analysis were compared to clinical findings and intraoperative macroscopic aspects. Results: The study included a total of 7 patients with a mean age of 52.15 years. The main histological findings in the skin and subcutaneous cellular tissue of the irradiated breast were as follows: epidermal hyperplasia, flattening of the papillary layer, atrophy of the skin appendages, vascular congestion in fatty tissue, high density of skin collagen fibers, hyalinization, and reduction of elastic fibers in the deep dermis and unidirectional alignment of collagen fibers. The main histological findings for the capsule and pectoralis major muscle in the irradiated breast were as follows: lower density of elastic fibrosis, perivascular fibrosis, synovial metaplasia, skeletal muscle sequestration at the interface with the capsule, capsular hyalinization, and capsular fribrosclerosis. Conclusion: We found common histological changes in irradiated breasts in most patients. These findings are compatible with the clinical and macroscopic changes observed. This study presents itself as a pilot for the development of further studies investigating the physiopathological mechanisms of the described histological changes.
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spelling doaj.art-bc268a4c550c4a98b370b399fcd5cfe92023-12-03T13:39:20ZengSociedade Brasileira de Cirurgia PlásticaRevista Brasileira de Cirurgia Plástica1983-51752177-12352020-03-013501445110.5935/2177-1235.2020RBCP0008Histological comparison between irradiated and non-irradiated breasts in breast reconstructionAlberto Benedik0Ronan Caputi Silva Dias1Amanda Costa Campos2Carolina Oliveira Paranagua Castro3Marcela Caetano Cammarota4José Carlos Daher5Hospital Daher Lago Sul, Brasília, DF, BrazilHospital Daher Lago Sul, Brasília, DF, BrazilHospital Daher Lago Sul, Brasília, DF, BrazilHospital Daher Lago Sul, Brasília, DF, BrazilHospital Daher Lago Sul, Brasília, DF, BrazilHospital Daher Lago Sul, Brasília, DF, BrazilIntroduction: The treatment of breast cancer includes not only curative therapies but also breast reconstruction. Radiotherapy, an adjuvant strategy, provides favorable outcomes by reducing the rate of recurrence of the disease. This study aimed to compare histological differences between irradiated and non-irradiated breasts in the same patient. Methods: This is a prospective cohort study of patients undergoing breast reconstruction with prosthesis or expander under pectoralis major muscle flap that compared histological skin patterns, subcutaneous cell tissue, pectoralis major muscle, and implant capsule of irradiated and non-irradiated breasts in paired samples of the same patient. All patients included in this study were irradiated in only one breast. The results of the anatomopathological analysis were compared to clinical findings and intraoperative macroscopic aspects. Results: The study included a total of 7 patients with a mean age of 52.15 years. The main histological findings in the skin and subcutaneous cellular tissue of the irradiated breast were as follows: epidermal hyperplasia, flattening of the papillary layer, atrophy of the skin appendages, vascular congestion in fatty tissue, high density of skin collagen fibers, hyalinization, and reduction of elastic fibers in the deep dermis and unidirectional alignment of collagen fibers. The main histological findings for the capsule and pectoralis major muscle in the irradiated breast were as follows: lower density of elastic fibrosis, perivascular fibrosis, synovial metaplasia, skeletal muscle sequestration at the interface with the capsule, capsular hyalinization, and capsular fribrosclerosis. Conclusion: We found common histological changes in irradiated breasts in most patients. These findings are compatible with the clinical and macroscopic changes observed. This study presents itself as a pilot for the development of further studies investigating the physiopathological mechanisms of the described histological changes.http://www.rbcp.org.br/export-pdf/2696/en_v35n1a08.pdfbreastbreast neoplasmsradiotherapyadjuvant radiotherapyprostheses and implants
spellingShingle Alberto Benedik
Ronan Caputi Silva Dias
Amanda Costa Campos
Carolina Oliveira Paranagua Castro
Marcela Caetano Cammarota
José Carlos Daher
Histological comparison between irradiated and non-irradiated breasts in breast reconstruction
Revista Brasileira de Cirurgia Plástica
breast
breast neoplasms
radiotherapy
adjuvant radiotherapy
prostheses and implants
title Histological comparison between irradiated and non-irradiated breasts in breast reconstruction
title_full Histological comparison between irradiated and non-irradiated breasts in breast reconstruction
title_fullStr Histological comparison between irradiated and non-irradiated breasts in breast reconstruction
title_full_unstemmed Histological comparison between irradiated and non-irradiated breasts in breast reconstruction
title_short Histological comparison between irradiated and non-irradiated breasts in breast reconstruction
title_sort histological comparison between irradiated and non irradiated breasts in breast reconstruction
topic breast
breast neoplasms
radiotherapy
adjuvant radiotherapy
prostheses and implants
url http://www.rbcp.org.br/export-pdf/2696/en_v35n1a08.pdf
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