Abstract

BackgroundTissue expanders are used in breast reconstruction after mastectomy to stretch the remaining tissue to create space for placement of permanent breast implants. The AeroForm™ Tissue Expander, developed by AirXpanders™ Inc., contains electronic components designed to activate the release of carbon dioxide from an internal reservoir to inflate the expander. Breast cancer patients who undergo mastectomy and tissue expander/implant-based breast reconstruction may require radiation therapy at doses up to 50–60 Gy while the expander is in place. The ionizing radiation used in postmastectomy radiation therapy interacts with electronic components in medical implants, which may cause degradation in performance above certain levels. Most commercial electronic components used in medical devices, such as complementary metal-oxide semiconductor or bipolar integrated circuits can withstand radiation levels in the 50 Gy range without any performance degradation. Beyond this level, the performance may still be sufficient to guarantee functionality, but this needs to be confirmed at the system and electronic circuit level. We assessed the impact of radiation levels up to 75 Gy on 32 AeroForm™ Tissue Expanders (AirXpanders, Inc., Palo Alto, CA USA) and on the associated internal printed circuit assemblies.FindingsThe electronics inside the AeroForm™ Tissue Expander implant continued to function properly after exposure to radiation levels up to 75 Gy, which is well above the maximum total dose level typically used in postmastectomy radiation therapy.ConclusionsStandard postmastectomy radiation therapy doses do not damage or affect the functionality of the AeroForm™ Tissue Expander.

Highlights

  • Tissue expanders are used in breast reconstruction after mastectomy to stretch the remaining tissue to create space for placement of permanent breast implants

  • Radiation parameters The cumulative doses typically used in postmastectomy radiation therapy are 50–60 Gy and are administered in fractions of 1.8-2.5 Gy/day over several weeks to minimize damage to tissue [7,8]

  • Threshold voltage variation is a measure of the impact of radiation on the tissue expander electronics

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Summary

Introduction

Tissue expanders are used in breast reconstruction after mastectomy to stretch the remaining tissue to create space for placement of permanent breast implants. Breast cancer patients who undergo mastectomy and tissue expander/ implant-based breast reconstruction may require radiation therapy at doses up to 50–60 Gy while the expander is in place. Most commercial electronic components used in medical devices, such as complementary metal-oxide semiconductor or bipolar integrated circuits can withstand radiation levels in the 50 Gy range without any performance degradation. Beyond this level, the performance may still be sufficient to guarantee functionality, but this needs to be confirmed at the system and electronic circuit level. We assessed the impact of radiation levels up to 75 Gy on 32 AeroFormTM Tissue Expanders (AirXpanders, Inc., Palo Alto, CA USA) and on the associated internal printed circuit assemblies

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