New York hospital offers at-home method for tissue expansion for breast reconstruction surgery

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NewYork-Presbyterian Hospital/Columbia University Medical Center is the first hospital in the New York metro area to offer breast cancer survivors an at-home method for tissue expansion in preparation for breast reconstruction surgery. Patients use a remote control to gradually create a space within their chest wall for a breast implant.

Breast cancer patients who wish to have reconstructive surgery after mastectomy have often had to undergo a process involving injections of saline to gradually expand skin and muscle of their chest. The process can be painful and may require frequent doctor's visits over the course of four to six months or longer.

"Unfortunately, less than half of all women who have mastectomies in the United States undergo reconstructive surgery. One major factor in this decision may be limitations of the traditional approaches," says Dr. Jeffrey Ascherman, NewYork-Presbyterian/Columbia's principal investigator of the study, site chief of the Division of Plastic Surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center, and professor of clinical surgery at Columbia University College of Physicians and Surgeons.

The new approach is designed to promote a higher quality of life for patients dealing with cancer recovery. Once a small expander device is implanted in the patient's chest, she can control the process in the comfort of her home — without any injections and with fewer doctor's visits. At a moment of the patient's choosing, a remote control is used to activate the device and release a small amount of compressed carbon dioxide.

"The whole process is also a lot quicker," says Dr. Ascherman. In a study of the device in Australia, in 15 days the CO2 method created a space for the breast that would normally have taken several months of saline injections.

The procedure is offered as part of an ongoing clinical trial designed to compare the outcomes of the traditional saline expansion method with the investigational, remote-controlled tissue expander. NewYork-Presbyterian/Columbia was the first center in the U.S. to receive Institutional Review Board (IRB) approval for a trial of the new technique, the first center in the U.S. to begin using the device, and it is currently the only hospital in the Eastern U.S. to be actively participating in the trial. Study funding is provided by AirXpanders Inc. of Palo Alto, Calif.

Eligible patients include non-obese women from 18 to 65 years of age who do not smoke, have not had previous tissue expansion or radiation therapy, and who are opting for breast reconstruction with tissue expansion after mastectomy.

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