Research

Introduction

We know that having your breast(s) reconstructed is a personal decision that has a tremendous impact on how you feel about yourself and your body. Our research is focused on understanding more about the personal impacts of breast reconstruction procedures on patient satisfaction and quality of life.

We currently offer every technique of reconstruction from DIEP flaps, to thigh and buttock flaps, as well as two-stage and one-stage implant based breast reconstructions. However, what no one knows is which one of these techniques provides the best long-term cosmetic result, has the least trauma on your body, and produces the greatest satisfaction in the long run. Therefore, the ultimate goal of our research is to acquire a better understanding of the impact of each procedure on these aspects of your life.

We have a number of breast reconstruction clinical trials comparing different procedures and questionnaire outcome studies that you may be interested in learning more about and our Clinical Research Coordinator, Kate Butler, is always available to provide more detailed information about each of these studies. She can be reached at: 416-340-4800 ext 2343 email: kbutler@uhnres.utoronto.ca

Your participation may not be of direct benefit to you but we hope that it will help us to improve patient care and benefit other women and breast cancer survivors choosing breast reconstruction surgery in the future.

Current Clinical Studies

Post Mastectomy Breast Reconstruction: A Comparative Study of the Psychological Implications of DIEP Flap and Implant Procedures
The goal of this questionnaire outcome study is to identify and compare the psychological and medical determinants of aesthetic satisfaction, psychosocial, body image and sexual functioning in women who undergo a DIEP flap or implant reconstructive procedure after their mastectomy.

Acellular dermal matrix in one-stage breast reconstruction: a RCT
The purpose of this multi-center randomized controlled trial is to evaluate the impact of implantable human cadaveric acellular dermal matrix in the setting of immediate one-stage implant breast reconstruction compared with a two-stage tissue expander/ implant procedure.
Toronto AlloDerm® Breast Implant Reconstruction Trial

An examination of quality of life in Canadian breast cancer survivors awaiting breast reconstruction
Unlike in the U.S. where immediate breast reconstruction (reconstruction that takes place in the same setting as the mastectomy) is the standard of practice, delayed breast reconstruction is most commonly performed in Canada. Furthermore most Canadian women spend many months waiting for this procedure to restore their mastectomy defect. The goal of this study is to evaluate the impact of wait-time on the quality of life in Canadian mastectomy women awaiting delayed breast reconstruction. Findings from this study will contribute to our limited understanding of the effect of prolonged surgical wait-list on this large subset of breast cancer patients.

Tissue Studies

We collaborate with a number of lab based researchers who are interested in studying different types of breast tissue and their role in the development of disease.

Genomic Instability in Primary Mammary Epithelial Cells
This laboratory study is designed to investigate how these normal cells can acquire changes that increase the risk of becoming cancerous. This information will help us understand the earliest events in breast cancer and provide novel targets for early detection, prevention or treatment of breast cancer, leading to reduced patient mortality and morbidity of patients with the disease.

Hypoxic Conditioning of Skeletal Muscle
In trauma surgery such as replantation of amputated hand, foot and limb, and decompression of compartment syndrome, a large mass of skeletal muscle is subjected to warm global ischemia (i.e. no blood flow) before the patient arrives at the hospital for surgery. Delay in surgery due to transportation of patients and/or surgical complications can prolong ischemic time, causing lethal ischemic insult to the skeletal muscle, which will necrose (die) even though the blood supply is eventually reconnected (i.e. reperfusion). This damage is known as ischemia/reperfusion injury. We have reported that instigation of brief cycles of occlusion/reperfusion in the pig skeletal muscle at the end of 4h ischemia was effective in salvage of the ischemic skeletal muscle from reperfusion injury. This phenomenon is known as postischemic conditioning (or postconditioning) but its effectiveness in human skeletal muscle is unknown. Here, we propose to use our published in vitro human skeletal muscle model to investigate the efficacy and mechanism of postconditioning for salvage of ischemic human skeletal muscle from reperfusion injury. Information to be obtained from this project will lead us to identify drug therapy for salvage of human ischemic skeletal muscle from reperfusion injury in trauma surgery.

Research coordinator: Kate Butler
Phone: 416-340-4800 ext 2343
Email: kbutler@uhnres.utoronto.ca

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