DIY breast re­con­struc­tion: De­vice gives women con­trol

Baltimore Sun - - WORLD - By Mar­i­lynn Mar­chione

This might be the ul­ti­mate do-it-your­self project: Doc­tors are test­ing a de­vice that would let women do part of their own breast re­con­struc­tion at home.

It’s aimed at not only mak­ing treat­ment more com­fort­able and con­ve­nient, but also giv­ing women a sense of con­trol — some­thing can­cer of­ten takes away.

More than 100,000 women each year in the United States have surgery to re­move a can­cer­ous breast, and many of them choose re­con­struc­tion with an im­plant.

To make room for a per­ma­nent one, many of them get a tis­sue ex­pander, a tem­po­rary pouch that is grad­u­ally en­larged with saline to stretch the re­main­ing skin and mus­cle.

This means trips to the doc­tor ev­ery week or two for sev­eral months for in­jec­tions of saline into the pouch, which can be a painful or­deal.

“We would put as much saline as we could un­til ba­si­cally the pa­tient would say, ‘I can’t stand it any­more,’ ” said Dr. Daniel Ja­cobs, a Kaiser Per­ma­nente plas­tic sur­geon in San Jose, Calif.

While bik­ing home one day, Ja­cobs had an idea: Why couldn’t a tiny can of com­pressed gas, like the one he car­ries to fix a flat tire, be used to let women in­flate their own tis­sue ex­panders, a lit­tle each day so there is less stretch­ing at a time and less pain?

He helped found a com­pany — AirX­pan­ders Inc. of Palo Alto, Calif. — to de­velop the de­vice, called AeroForm.

It’s sold in Aus­tralia, ap­proved in Europe and un­der re­view by the U.S. Food and Drug Ad­min­is­tra­tion.

Its use re­quires no spe­cial train­ing, wires or tubes — just a palm-sized re­mote con­trol that ac­ti­vates a tiny car­tridge inside the pouch to pump gas, up to three times a day ac­cord­ing to how the woman feels.

In a com­pany-spon­sored study of 150 women, AeroForm pa­tients fin­ished tis- sue expansion in half the time and were able to get im­plants a month sooner than oth­ers who had the usual saline treat­ments, said the study leader, Dr. Jef­frey Ascher­man, a plas­tic sur­geon at New YorkPres­by­te­rian/ Columbia Med­i­cal Cen­ter in New York.

“My pa­tients love it,” he said.

There was no dif­fer­ence in rates of side-ef­fects such as in­fec­tions, but seven of the air ex­panders mal­func­tioned ver­sus only one saline one, Ascher­man said.

The de­vice was tweaked to fix the prob­lem, he said.

“It’s a re­ally in­ter­est­ing con­cept,” said one out­side ex­pert, Dr. Deanna At­tai, a Univer­sity of Cal­i­for­nia at Los An­ge­les sur­geon who is a past pres­i­dent of the Amer­i­can So­ci­ety of Breast Sur­geons.

“Giv­ing the pa­tient a sense of con­trol is very psy­cho­log­i­cally im­por­tant,” be­cause many women feel robbed of that, At­tai said.

“To a pa­tient that’s go­ing through can­cer treat­ment that could be a big deal.”

MARY ALTAFFER/AP

Luin­cys Fer­nan­dez demon­strates how she used the AeroForm hand-held dosage con­troller to stretch skin and mus­cle to make room for an im­plant af­ter breast can­cer.

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