[abstract]EFFECTS OF HYPERBARIC OXYGEN THERAPY IN BREAST CANCER PATIENTS UNDERGOING RECONSTRUCTIVE SURGERY IN IRRADIATED TISSUE

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[abstract]EFFECTS OF HYPERBARIC OXYGEN THERAPY IN BREAST CANCER PATIENTS UNDERGOING RECONSTRUCTIVE SURGERY IN IRRADIATED TISSUE

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Title: [abstract]EFFECTS OF HYPERBARIC OXYGEN THERAPY IN BREAST CANCER PATIENTS UNDERGOING RECONSTRUCTIVE SURGERY IN IRRADIATED TISSUE
Author: Gwilliam A; Mackintosh R; Robins MS
Abstract: INTRODUCTION: Breast cancer causes significant morbidity and mortality in women of all backgrounds. It is estimated that 12.4 percent of women born in the United States will develop breast cancer during their life [1]. Treatment options include surgery, chemotherapy and radiation. Radiation therapy and mastectomy are often utilized together for advanced metastatic cancer [2]. Radiation therapy is considered essential; thus managing complications becomes essential. Delayed radiation complications (damaged microvasculature and ischemia) may manifest from six months to years later after the radiation exposure [3]. Elective surgery is relatively contraindicated in areas of previous radiation, and may impact patients desiring breast reconstructive surgery [4]. METHODS: Three breast cancer patients underwent chemotherapy, radiation and mastectomy surgery. Incisions healed completely. Surgical breast reconstruction was undertaken several months post-mastectomy. The irradiated areas subsequently dehisced, necessitating implant removal. Patients had large open wounds, with significant tissue deficit. Advanced wound care was initiated (hydrofiber, foam or negative-pressure wound therapy) with minimal effect. The patients were dissatisfied with their self-image and altered appearance. Any additional surgical procedure would net the same results. An additional intervention was needed to change the outcome. Patients received 30 hyperbaric oxygen (HBO2) treatments over a six-week period. These patients then underwent a second reconstructive surgery with primary closure and 10 additional HBO2 treatments. RESULTS: None experienced additional complications,and all had complete healing. Patients overwhelmingly verbalized satisfaction with their appearance and outcome. SUMMARY: Most patients who have undergone mastectomy with radiation and subsequent breast reconstruction heal without further interventions. However, a small percentage of patients will experience late effects of radiation. For this population, HBO2 therapy can significantly improve quality of life, enhance self-image, eliminate wound care expense and decrease risk of infection. Limitations are minimal, mostly based on tolerance of HBO2. HBO2 stimulates angioneogenesis and increases oxygen content in irradiated tissue, promoting wound-healing ability [5]. References 1. National Cancer Institute, National Institute of Health (2012). Breast Cancer Risk in American Women. Retrieved 11/19/12 from http://www.cancer.gov/cancertopics/factsheet/detection/probability-breast-cancer 2. Fowble B, Gray R, Gilchrist K. (1988). Identification of a sub-group of patients with breast cancer and histologically positive axillary nodes receiving adjuvant chemotherapy who may benefit from post-operative radiotherapy. J Clin Oncol, 6, 1107-1117. 3. Feldmeier J, Packard M. (2008). Delayed radiation injuries (soft tissue and bony necrosis). In L. Gesell, (ed.), Hyperbaric Oxygen Therapy Indications. 12th ed. (pp. 145-147) Durham: Undersea and Hyperbaric Medical Society. 4. Marx RE, Ehler WJ, Tayapongsak P, Pierce LW. (1990). Relationship of oxygen dose to angiogenesis induction in irradiated tissue. Am J surg, 160, 519-524. 5. Hampson NB. (2010). Viewpoints: Hyperbaric oxygen and reduction mammoplasty in the previously irradiated breast. American Society of Plastic Surgeons. 125:6, 255e-257e.
Description: Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society, Inc.
URI: http://archive.rubicon-foundation.org/10752
Date: 2013

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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