Evaluation of an <i>in Situ</i> Polymerizing Hydrogel Applied in Tumor Excision Cavities during Breast Conservation Surgery

Abstract

Study Objective: To evaluate the imaging characteristics and healing following application of an absorbable biocompatible hydrogel into the excision cavity following breast conservation surgery. Design: Non-randomized study evaluating hydrogel application feasibility, post-operative hydrogel imaging characteristics, cavity healing following hydrogel absorption and the resulting breast cosmesis. Setting: Teaching hospital University of Essen, Germany. Patients: Seven (7) patients underwent unilateral or bilateral breast conservation surgery to remove cancerous or benign tumors. Interventions: All patients received hydrogel application following primary tumor excision. Imaging performed in the first postoperative week included ultrasound, MRI and CT. Breast cosmesis scores were obtained at one and three months following surgery. Measurements and Main Results: While preliminary, a relationship between percent cavity filling and drainage was observed, with 30% or more cavity filling resulting in decreased drainage. Additionally, the hydrogel was readily visible under ultrasound, MRI and CT imaging modalities. Finally, patients were satisfied and surgeons felt that patient cosmesis was improved relative to their prior experience. Conclusion: Initial data suggest that hydrogel filling may reduce excision cavity drainage, which may reduce seroma or hematoma formation. Additionally, these gels may improve cavity visibility and stability, furthering the use of partial breast irradiation. Finally, while more studies are required, these materials may have a role in improving long term patient cosmesis.