Creation and Implementation a Method for Breast Reconstruction After Radical Surgery Using Decellularized Xenomatrix in Combination With Lymphovenous Anastomosis in Breast Cancer.
Creation and Implementation a Method for Breast Reconstruction After Radical Surgery Using Decellularized Xenomatrix in Combination With Lymphovenous Anastomosis in Breast Cancer.
In 2020, over 31,000 new cancer cases were reported in Kazakhstan, and breast cancer was the most common type, with more than 4,200 new cases. This pattern has been seen in previous years as well. Because of how common breast cancer is, it's a major concern not only for individuals but also for the country's overall public health.
Thankfully, most breast cancer cases (about 94%) are found in the early to middle stages (stages I-III), when treatment is usually possible. However, treatment-especially surgery-can still be physically and emotionally challenging. After surgery, some patients experience complications like scarring or swelling (lymphedema). Additionally, losing a breast can deeply affect a woman's body image, sense of femininity, and overall mental well-being. These emotional effects can make it harder for patients to return to their normal lives.
To help improve recovery and quality of life, modern medicine now often recommends immediate breast reconstruction, where a breast implant is placed during the same surgery that removes the tumor. This approach has become the gold standard in breast cancer care.
However, for patients with breast cancer, placing implants is more complex. Doctors often need to use special materials-called fixation devices-to hold the implant in place. Most of these devices are made from synthetic (man-made) materials like plastic meshes. Unfortunately, these materials can sometimes cause inflammation or be rejected by the body.
In 2018, a new option was proposed: using biological materials made from animal tissue (called acellular collagen matrices). These materials are designed to work better with the body and reduce the chance of complications. They have shown promise in practice, but they're very expensive, and their performance can vary depending on how they're made and where they come from.
To address this, a team of Kazakhstani researchers developed a local alternative called AXM, made from specially treated cow tissue (bovine peritoneum). AXM has already shown good results as a wound covering in both lab and clinical settings, including use inside the body.
Now, researchers are studying whether AXM can also work effectively as a support material for breast implants in cancer patients. Because implant fixation requires strong, stable support, and different biological materials behave differently in the body, more research is needed to confirm whether AXM is a safe, reliable, and cost-effective solution for breast reconstruction.
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According to official statistical data for 2020, there were 31,505 cases of primary detection of oncological diseases registered in the territory of Kazakhstan. Among them, malignant breast neoplasms accounted for 4,272 cases, occupying a leading position [2]. This trend has been observed in previous years as well. This state of affairs certainly actualizes the issue of breast cancer not only against the background of other diseases, but also the morbidity of the population as a whole. Despite 94.3% of detected cases of breast cancer being registered at stages I-III and being amenable to treatment, the treatment itself remains a significant challenge for patients [2, 5]. As a result of the undergone surgical interventions, patients may develop delayed complications such as scar contractures and lymphedema. From a psychological perspective of socialization and quality of life, the loss of a breast can be perceived by women as a loss of femininity and can cause psychological disorders related to body aesthetic deformity and self-perception, which disrupts the socialization of breast cancer patients in the long term. In modern oncomammology, the gold standard is the performance of immediate breast reconstruction using implants [5, 6]. Despite the large number of breast implants available on the market, the specificity of implantation in cases of malignant breast neoplasms is complicated by the need to create an additional fixation apparatus to secure the implant. Mesh implants based on polytetrafluoroethylene and other hydrocarbon compounds are predominantly used as fixation materials. However, the use of such materials often leads to rejection and reactive inflammation. As an alternative, in 2018, Nakhabadaya proposed the use of acellular collagen matrices of animal origin [6]. These materials have proven themselves to be effective; however, there are several studies (Matyushkova, 2016; Codner, 2016) that show that xenogeneic materials of different origins and preparation methods behave differently on the wound surface and in the body as a whole. Another significant drawback is the high market cost of such materials, which has created a need for the development and implementation of domestic analogs. In the 2010s, a group of domestic scientists led by Abugaliyev K.R., Ogai V.B., and others developed and patented a domestic wound covering based on acellular bovine peritoneum, AXM [17, 18]. This invention has proven successful as a wound covering in preclinical and clinical stages, including intraorgan use [19]. However, considering that the fixation of a breast implant requires efforts to tension the matrix and the differences in behavior of collagen matrices of different origins, the effectiveness and reliability of the domestic acellular xenogeneic matrix as a fixation apparatus for breast implants remains a question.