TITLE:
Evaluation of an in Situ Polymerizing Hydrogel Applied in Tumor Excision Cavities during Breast Conservation Surgery
AUTHORS:
M. Korell, F. Brassel, J. Pagels
KEYWORDS:
Lumpectomies; Breast Radiation; Seroma Prevention; Breast Cosmesis
JOURNAL NAME:
Surgical Science,
Vol.4 No.10,
October
30,
2013
ABSTRACT: Study
Objective: To evaluate the imaging characteristics and healing
following application of an absorbable biocompatible hydrogel into the excision
cavity following breast conservation surgery. Design: Non-randomized
study evaluating hydrogel application feasibility, post-operative hydrogel
imaging characteristics, cavity healing following hydrogel absorption and the
resulting breast cosmesis. Setting: Teaching hospital University of
Essen, Germany. Patients: Seven (7) patients underwent unilateral or bilateral
breast conservation surgery to remove cancerous or benign tumors. Interventions: All patients received hydrogel
application following primary tumor excision. Imaging performed in the first
postoperative week included ultrasound, MRI and CT. Breast cosmesis scores were
obtained at one and three months following surgery. Measurements and Main Results: While preliminary, a relationship between percent cavity filling and
drainage was observed, with 30% or more cavity filling resulting in decreased
drainage. Additionally, the hydrogel was readily visible under ultrasound, MRI
and CT imaging modalities. Finally, patients were satisfied and surgeons felt
that patient cosmesis was improved relative to their prior experience. Conclusion: Initial data suggest that hydrogel
filling may reduce excision cavity drainage, which may reduce seroma or
hematoma formation. Additionally, these gels may improve cavity visibility and
stability, furthering the use of partial breast irradiation. Finally, while
more studies are required, these materials may have a role in improving long
term patient cosmesis.