Thank you for your generous support of the C-TRAK trials at The Royal Marsden.
“55,000 women will be diagnosed with breast cancer each year, and around 15% of these cases will be triple negative breast cancer (TNBC). TNBC does not respond to common therapies such as tamoxifen or Herceptin and has a high rate of recurrence. Relapsed TNBC is often not visible on a CT or MRI scan until it is too large to be treated. Funding from Breast Cancer Research Aid has enabled a clinical trial – C-TRAK – which is trying to improve diagnosis and treatment for TNBC. The first part of the trial is attempting to identify relapsed TNBC before it is too late to be treated by identifying specific circulating tumour DNA (ctDNA) in the patients’ blood. Patients’ with TNBC will have their blood tested every three months for two years in the hope of using the ctDNA to identify a relapse in their condition. Any patients who are found to have relapsed will then be randomized into the second part of the trial which will see them either observed or receiving pembrolizumab for one year. As of October 2019, C-TRAK has recruited 180 patients with TNBC. Our target is to recruit 200 patients, and so we will be able to begin ctDNA surveillance soon.”
A new type of drug that blocks one of cancer’s key evolutionary escape routes from chemotherapy could be used to treat aggressive breast cancers, a new study has shown.
Scientists at The Institute of Cancer Research, London, found that the drug could reinvigorate the response to chemotherapy in cancers that had become resistant, in both cells grown in the lab and in mice.
The drug, known as BOS172722, works by forcing cancer cells through cell division too quickly – leading to fatal errors in parcelling out DNA.
The first clinical trial of the new treatment is now under way in solid tumours including aggressive triple-negative breast cancers – and the researchers believe it might also be effective against other fast-growing cancers including ovarian cancer.
The drug was discovered at the ICR in the Cancer Research UK Cancer Therapeutics Unit. It blocks a molecule called MPS1, which plays a central role in controlling cell division.
MPS1 is involved in organisation of chromosomes during cell division, ensuring they are distributed correctly between daughter cells and making sure that cell division doesn’t go ahead until they have been parcelled out evenly.
By blocking MPS1 using the new drugs, cancer cells speed through cell division with the wrong number of chromosomes and die as a consequence.
The ICR researchers found that cancer cells in dishes treated with the MPS1 inhibitor went through cell division in just 11 minutes, compared with 52 minutes without the drug.
And fast-dividing cells, from triple-negative breast cancers, ovarian and lung cancers, were especially sensitive to the effects of blocking MPS1.
Currently, people with triple-negative breast cancer receive taxane chemotherapies, such as paclitaxel, as their standard care. Paclitaxel also affects the distribution of chromosomes during cell division but blocks the cell from dividing, which causes the cell to die. However, some cells escape becoming resistant to the drug and giving rise to more tumours.
Phase I trial under way
Treatment with paclitaxel in combination with BOS172722 dramatically reduced time in cell division – from 110 minutes with paclitaxel alone to 15 minutes when combined with BOS172722. All cells treated with the combination divided with gross chromosomal abnormalities and died as a result, whereas 40 per cent remained alive with paclitaxel alone.
The MPS1 inhibitor was also effective at lower doses when used in combination with paclitaxel in mice, and was well tolerated by mice at the doses that almost completely eliminated the tumours.
“We have discovered a brand new type of cancer treatment that uses cancer’s rapid growth against it, by forcing cells through cell division so quickly that they accumulate fatal errors. The drug works especially well in combination with chemotherapy in triple negative breast cancer cells – the deadliest form of breast cancer for which there are few successful treatments.
“Crucially, the combination is anticipated to be effective in cancer patients that have already become resistant to chemotherapy alone and has the potential to become a much-needed extra treatment option that could extend the lives of patients.
“The phase I trial of this combination is currently well under way and I look forward to the results.”
World’s first ‘Darwinian’ drug discovery programme
“Cancer’s ability to evolve and become drug resistant is the cause of the vast majority of deaths from the disease. We plan to counter that ability with the world’s first ‘Darwinian’ drug discovery programme within our Centre for Cancer Drug Discovery, dedicated to creating a new generation of anti-evolution treatments.
“Our new MPS1 inhibitor is a great example of a drug that seeks to outsmart cancer by blocking off a key evolutionary escape route, and in doing so we believe it can breathe new life into a chemotherapy that had ceased to be effective.”
Baroness Delyth Morgan, Chief Executive at Breast Cancer Now, which helped to fund the study, said:
“It’s really promising that combining this newly-discovered drug with a standard chemotherapy could, in future, provide a new way to treat triple negative breast cancer and may even prevent the disease from becoming resistant to treatment.
“With triple negative breast cancer still lacking in targeted treatments, we urgently need to find new options to stop more women dying. This exciting study shows how well these drugs complement each other at a molecular level to destroy cancer cells.
“We now look forward to the results of clinical trials to understand whether this approach may be as effective and safe in humans. In the meantime, anyone with questions about their breast cancer treatment can call our free Helpline on 0808 800 6000 to speak to one of our expert nurses.”
I am getting in touch to thank you for your recent donation of £3,000 towards our breast cancer research here at The Institute of Cancer Research. This gift takes your total donations to the ICR to a staggering £40,000! We are so grateful to have your continued support.
A personalised blood test for women with early breast cancer could detect the return of the disease nearly eleven months earlier than hospital scans, a new study at five UK hospitals has found.
The study, funded by Breast Cancer Nowand other collaborators, found that the test for levels of cancer DNA circulating in the blood detected the return of the disease after treatment on average 10.7 months before patients developed symptoms or secondary tumours became visible on scans.
The test, developed by scientists at The Institute of Cancer Research, LondonandThe Royal Marsden NHS Foundation Trust,was found to work in all types of breast cancer, and could detect the early signs of the spread of the disease around the body (outside of the brain).
Further research is now needed to understand how the test could be used in the clinic to help guide treatment and improve patient outcomes, with UK trials now underway to assess new treatments alongside the test in triple negative breast cancer.
Who is the test for?
Breast cancer is the UK’s most common cancer, with around 55,000 women and 350 men being diagnosed each year in the UK.
While more women are now surviving the disease than ever before thanks to research progress and advances in NHS treatment, recurrences are still common and happen when breast cancer cells survive initial treatment and grow into new tumours.
In cases where the disease returns and spreads to form tumours in other parts of the body, known as metastatic or secondary breast cancer,while it can be controlled for some time it unfortunately cannot be cured. Almost all of the around 11,500 women and 80 men that lose their lives to breast cancer each year in the UK will have seen their cancer spread.
‘Liquid biopsies’ ― blood tests that can detect cancer DNA in the bloodstream ― have emerged as an exciting new field in cancer research in recent years. The tests aim to monitor how a patient’s cancer is responding to treatment in real-time, detect emerging resistance to treatment and spot any recurrences at the earliest possible stage.
Analysing cancer DNA to predict recurrence
In a new prospective study of 101 women across five UK hospitals, scientists led by Professor Nicholas Turner in the Breast Cancer Now Research Centre at The Institute of Cancer Research (ICR) assessed the potential of a new personalised blood test to detect recurrence in patients diagnosed with early breast cancer who had no signs of secondary tumours.
The tests are tailored to the make-up of each woman’s tumour to enable the levels of cancer DNA in their bloodstream to be monitored.
By analysing cancer DNA from tumour samples collected before treatment, the researchers identified mutations that could distinguish cancer DNA from all other DNA in the blood and could be tracked over time. Overall, in the 101 patients, 165 different trackable mutations were found, with 78 participants having one trackable DNA mutation and 23 patients having multiple mutations.
Blood samples were collected from participants every three months during their first year after treatment, and then every six months for up to five years thereafter.
To assess the test’s ability to detect recurrence at a molecular level in different breast cancer sub-types, the researchers combined the data with a previous proof-of-principle study to establish a bigger cohort of 144 patients.
At follow-up of approximately three years, 29 of 144 patients had seen their breast cancer return. 23 of these 29 patients had cancer DNA detected in their blood prior to relapse, with the ‘liquid biopsies’ spotting the signs of recurrence on average 10.7 months before their clinical diagnosis.
‘A new treatment paradigm for breast cancer’
With the test accurately indicating the return of breast cancer across all major subtypes, the authors suggest that upcoming trials could lead to “a new treatment paradigm for breast cancer”, in which therapy could be offered at the first signs of relapse at a molecular level, rather than at a later stage once symptoms have appeared.
In addition, the researchers also conducted a sub-analysis of 80 patients who had blood samples taken at their diagnosis – with circulating cancer DNA being detected in 41 of these women. These patients were found to be 5.8 times more likely to experience a relapse during the first three years after treatment than those without detectable levels of cancer DNA prior to treatment – demonstrating that the test may also have prognostic potential in the future.
Professor Nicholas Turner, Professor of Molecular Oncology at The Institute of Cancer Research, London, and Consultant Medical Oncologist at The Royal Marsden NHS Foundation Trust, said:
“These new blood tests can work out which patients are at risk of relapse much more accurately than we have done before, identifying the earliest signs of relapse almost a year before the patient will clinically relapse.
“We hope that by identifying relapse much earlier we will be able to treat it much more effectively than we can do now, perhaps even prevent some people from relapsing. But we will now need clinical trials to assess whether we can use these blood tests to improve patient outcome. We have launched the first of these studies already, and hope to launch large studies in the future.”
‘Extremely exciting’ potential
Dr Simon Vincent, Director of Research at charity Breast Cancer Care and Breast Cancer Now, which funded the study, said:
“This could be a really significant breakthrough. The potential of this blood test to in future spot the signs of breast cancer returning or spreading much earlier in NHS clinics is extremely exciting.
“But we now need upcoming trials to identify whether offering treatments to patients at this stage could actually help intervene and improve their chances of survival or quality of life.
“The fact that these tests are personalised to each patient to try to find out whether any cancer cells remain and are on the move is unique. But for thousands of women, a blood test like this and the hope of new treatments to stop the disease returning just cannot come soon enough. The fear of breast cancer coming back can have a major impact on patients’ lives, and we urgently need to do more to support them, as well to increase awareness of the signs and symptoms of secondary breast cancer.
“While most aches, pains or coughs won’t mean the cancer is back, we’d encourage all women to report any new, unexplained or persistent changes to their GP or breast care team. Anyone feeling worried about their breast cancer returning can call our free Helpline on 0808 800 6000 and speak to one of our nurses.”
The researchers first identified AKR1B10 in a screen for proteins which, when expressed at high levels, helped cancer get ahead at new locations, while low levels of the protein hinder its growth in new organs.
Cells normally avoid using fatty acids for fuel as there are toxic side effects. High levels of AKR1B10 limit these toxic side effects, allowing cancer cells to thrive in new areas in the body.
The opposite is also true – switching off the cancer cells’ ability to use fatty acids reduces their ability to form tumours at new sites in the body.
“Cancer cells have to work hard to take root and form a tumour. When tumour cells head on the move to other parts of the body, a process called metastasis, they have to work even harder to adapt to the energy and nutrient sources available to them wherever they find themselves, as well as surviving the journey.
“Our study has shown the importance of cancer cell learning how to use different nutrients and energy sources in order to survive.
“We found that high levels of the protein AKR1B10 help tumour cells adjust to new environments as cancer spreads from the breast to other organs such as the lungs.
“This research significantly improves our understanding of cancer cell metabolism and metastatic relapse and could lead to new avenues of exploration for new therapies and treatments for patients with metastatic breast cancer.”
NICE has paused its appraisal of olaparib for NHS patients with breast cancer while waiting for manufacturer AstraZeneca to submit new data, and is not now planning to restart its review until around July.
The Institute of Cancer Research, London, discovered the genetic targeting of olaparib – which became the first cancer drug directed against an inherited genetic fault when licensed by the EMA for BRCA-mutation ovarian cancer in December 2014.
In a statement, the ICR welcomed the approval of olaparib for breast cancer as an important step towards making it available for NHS patients – but also criticised delays in making the drug available in Europe.
“It’s fantastic news that olaparib has finally been given the green light by the EMA for people with BRCA-mutant breast cancer. But it’s also been enormously frustrating for patients across Europe to have had to wait so long to get the drug.
“Olaparib is an extremely innovative treatment which was the first cancer drug in the world to target inherited genetic faults. Yet it’s taking far too long for pioneering drugs like this to reach patients and we need to do more to fast-track the most exciting new treatments into the NHS.
“The EMA and NICE have started to be more nimble and flexible in their evaluation of evidence, but there is still more they could do and much that they could learn from best practice in the US and elsewhere.”
Researchers at The Breast Cancer Now Toby Robins Research Centre lead important study programmes to understand the genetic and environmental causes of breast cancer.
Professor Andrew Tutt, who is Director of the Breast Cancer Now Research Centre at the ICR, was part of the early laboratory research at the ICR behind PARP inhibitors in patients with BRCA mutations, and led some of the early clinical trials of olaparib for BRCA-mutant breast cancer.
Responding to the decision, Professor Tutt said:
“Although the delays have been disappointing, I am delighted olaparib has now been licensed in Europe for advanced breast cancer in women who have inherited BRCA1 or BRCA2 mutations. It is excellent news for patients with this form of breast cancer.
“Olaparib is the first drug to be approved that is directed against an inherited genetic mutation. It is a perfect example of how understanding a patient’s genetics and the biology of their tumour can be used to target its weaknesses and personalise treatment.”
Emma Clarke, 46 from Cheshire, was diagnosed with primary breast cancer in 2016, and secondary breast cancer spread to her bones in 2018. Later genetic testing discovered she carried a BRCA1 mutation. She is currently being treated with chemotherapy and is due to begin radiotherapy soon. Her daughter recently discovered she also has the BRCA1 mutation.
“I have done a lot of research into my type of cancer – about having a BRCA1 mutation and the possible treatments available for me. Because I have the BRCA1 mutation, and that carboplatin is working well for me at the moment, I found out that olaparib has a good chance or working well for me and that it is already available in the US.
“I’m fortunate enough to be a private patient and have asked my doctor about starting olaparib, which I will begin taking as a maintenance treatment when my radiotherapy finishes in June.
“I whole heartedly support progress in targeted therapies and getting these to patients as soon as possible. Targeted therapies are at the forefront of treatments for patients, and give such hope at extending lives while living with fewer side effects than traditional chemotherapies.
“I was really surprised to see the length of the time gap between olaparib being available in the US and it being approved by the EMA. I hope for all the other BRCA+ breast cancer patients in this country that it is available on the NHS as soon as possible.
“With advanced-staged cancers like my own, once you have good evidence that a new targeted treatment is shown to work and extend lives, it should be available to patients.”
Video: Dr Ben O’Leary discusses a new blood test for women with advanced breast cancer which can predict how well patients will respond to a new drug right at the start of treatment.
A new blood test for women with breast cancer can predict how well patients will respond to a new drug right at the start of treatment.
The new blood test detected genetic changes within women’s breast cancers which indicated that these patients were less likely to respond to treatment – and that their disease could be expected to come back quickly.
Targeted drugs have shown benefit for many women with advanced breast cancer, but some patients stop responding soon after starting treatment as their cancer evolves to become drug resistant.
In future, the new test could help identify nearly half of women with the most common form of breast cancer who are at the highest risk of early relapse – who will need further trials of new treatments to stop their cancer becoming resistant – as well as identifying those who will do very well on treatment.
Many scientists from The Institute of Cancer Research, London are attending the 2019 ASCO conference in Chicago. See all of our news, blog and video content from the event.
Scientists at The Institute of Cancer Research, London, analysed fragments of cancer DNA that have entered the bloodstream to study the effect of genetic changes in a woman’s tumour – often called liquid biopsies.
They took blood samples from 310 women with oestrogen receptor positive breast cancer – the most common form of the disease – who were taking part in a clinical trial of palbociclib and fulvestrant for advanced breast cancer.
The team found that 131 women – 42 per cent – had one or more of three changes in the tumour DNA circulating in the bloodstream that put them at risk of early relapse.
Researchers at The Institute of Cancer Research (ICR) – a charity and research institute – and The Royal Marsden NHS Foundation Trust examined the impact of specific genetic changes within patients’ cancers at the start of treatment.
Women whose circulating tumour DNA contained changes in the well-known cancer gene, p53, saw their cancer come back after an average of 3.7 months, compared with 12.7 months in women without p53 gene changes.
An increase in the number of FGFR1 gene copies and a high level of tumour DNA in the bloodstream also shortened the average time before a woman’s cancer came back.
Women with these changes in circulating tumour DNA saw their cancer return after an average of 3.9 months compared with 12 months in women without these changes.
The study also found a link between faults in the p53 gene and the number and location of sites in the body to which cancer had spread.
Next, the blood test needs to be evaluated as part of different clinical trials to assess its value in other groups of patients, before it can start benefiting women with advanced breast cancer in the clinic.
The research follows a recent announcement by the ICR of a £15 million fundraising drive to complete a new £75 million Centre for Cancer Drug Discovery focusing on overcoming cancer evolution and drug resistance.
“Exciting new targeted treatments like palbociclib are beginning to have a real impact on survival for women with breast cancer, but unfortunately many tumours which initially respond will later develop resistance and come back.
“Our study found that a new genetic test could detect right at the start of treatment those women whose cancers were most likely to develop resistance quickly to palbociclib. We could then adjust their treatment plan accordingly – trialling additional treatments from the outset to try and prevent resistance, or planning for a switch to another treatment as soon as resistance develops. We now need to assess in a clinical trial whether helping direct women’s care with this new test can offer improved survival and quality of life.”
We are building a new state-of-the-art drug discovery centre to create more and better drugs for cancer patients.
“Cancer’s ability to evolve to become resistant to treatment is the greatest challenge we face in improving patients’ survival and quality of life.
“So-called liquid biopsy tests like this one are a key part of our toolkit in staying on top of cancers’ adaptability and evolution, and picking up the earliest signs of drug resistance. Detecting the potential of cancers to evolve resistance could allow us to predict cancer’s next move and to respond with adaptable new treatment plans.
“This study is a demonstration of the exciting new ‘Darwinian’ approach to treatment we will be taking once we have raised the money to complete our new £75 million Centre for Cancer Drug Discovery.”
Every year our researchers submit outstanding pictures to our Science and Medical Imaging Competition – telling a story about our pioneering work and its benefits for patients. Check out the fantastic images selected by our judges, and this year voted for by the public.
Each year, The Institute of Cancer Research runs a Science and Medical Imaging Competition – designed to cater for the moments in the lab or the clinic where science meets art.
The entries we receive for the competition have all been created in the course of our pioneering cancer research – but they are also exceedingly beautiful, and wonderfully effective at conveying broad messages about our work.
‘Divide and conquer’
The winner of this year’s competition – ‘Divide and conquer’ by ICR postdoc Dr Maxine Lam – is a great example. It shows a replicating cancer cell in vivid detail as it invades through blood vessels – and communicates something about the lethal process of cancer metastasis that words alone often struggle to convey.
Metastasis is one of the most challenging aspects of cancer, because it often makes the difference between life and death. Once cancer has spread to other parts of the body we have few effective treatments, and the disease is often fatal.
Scientists are therefore keenly interested in understanding how cancer cells spread so they can find ways of stopping it from happen.
And that has led to the development of ever more sophisticated and powerful imaging technologies so researchers can watch the process in action over time.
“I’m really excited and honoured to have won”
Dr Lam’s winning image was taken using a technology called confocal microscopy, and shows a cancer cell in pink invading through a layer of blood vessel cells, in yellow and cyan. The cancer cell has created a gap in the layer of blood vessel cells as it invades.
The picture illustrates a key step in metastasis called extravasation – where cancer cells move out of a blood vessel into tissue to spread to secondary tumour sites. Despite the importance of this step, very few models exist in the lab to directly visualise and understand it.
In the image white DNA inside the cancer cell has condensed into bright rods. This means that the cancer cell is in the process of dividing itself, even as it is invading – a remarkable yet terrifying sight. Dr Lam’s lab is using images like this to identify factors that could prevent cancer cells from being able to move and spread.
Dr Lam said: “I’m really excited and honoured to have won the ICR Science and Medical Imaging competition. This image captures two important moments in the life of a cancer cell, when it divides to make new copies of itself and when it leaves the circulation and invades new tissues, which is one of the most dangerous aspects of cancer.
“Seeing this process in action helps us to better understand how cancer spreads, and I hope this will help with developing new treatments.”
We also this year carried out our first ever public vote, asking our supporters on social media to choose their favourite from the judge’s shortlist.
There was lots of agreement between the judges and the public, but the vote picked a different winner – a stunning time-lapse image of a breast cancer cell on the move by PhD student Patricia Pascual Vargas.
Patricia Pascual Vargas’ photograph: Time-lapse image of a breast cancer cell on the move
Cancer cells can take on many shapes, squeezing through tissues and finding their way into places they shouldn’t be, using a complex network of adhesion molecules on their surfaces to move around.
Patricia’s image was taken using another type of technology called a total internal reflection fluorescence microscope (TIRF), and shows a very aggressive type of triple-negative breast cancer cell sensing its environment, by making contact through structures called focal adhesions.
This time-lapsed image uses different colours to show the position of focal adhesions over time. The yellow and red colours represent shorter adhesion times, and show that the cell is moving down and to the left.
Patricia and her colleagues are looking at how targeting certain genes affects the formation of adhesions, changing the cell’s shape and how it moves. It could be possible to prevent cancer cells from spreading around the body, making cancer easier to treat.
Patricia said: “I’m thrilled to have won the first ever public vote. My image helps to demonstrate that cancer cells aren’t static – they move and change shape, and this important characteristic helps them to adapt to their environment. By pinpointing how cancer cells do this we could prevent them from changing shape and stop them from spreading, which could save patients’ lives.”
Our fantastic shortlist
With another year of so many astounding entries, it’s important to recognise all of the fantastic images that made it onto our shortlist.
David Mansfield’s photograph: Cells within a tumour visualised before (left) and after (right) radiotherapy
This image shows cells within a tumour visualised before (left) and after (right) radiotherapy. Coloured immune cells move in to clear up the tumour cells in white, left behind after treatment. This helps the body gain vital anti-tumour immunity and long-term protection from recurrent disease.
Multiple members of the Clinical Studies Division
Detecting immune cell populations in a liver biopsy by Dr Mateus Crespo Dr Bora Gurel, Ana Ferreira, Rita Pereira, and Professor Johann de Bono, Division of Clinical Studies.
Photograph by multiple members of the Clinical Studies Division: Detecting immune cell populations in a liver biopsy
This multi-coloured image was taken using multiplex immunohistochemistry to light up a liver biopsy from a patient with metastatic cholangiocarcinoma, an aggressive cancer of the bile duct. Liver cells in yellow are being infiltrated by immune system T-cells in red and green.
The exploding nuclei – using combination drug treatments to overcome DNA damage repair mechanisms in cancer cells, by Parames Thavasu, Division of Cancer Therapeutics.
Parames Thavasu’s photograph: cells of an aggressive form of breast cancer called triple-negative breast cancer
This image shows cells of an aggressive form of breast cancer called triple-negative breast cancer, which is difficult to treat and has poor outcomes. After treating with a drug combination that causes damage to DNA at different stages of cell division, ‘explosive’ damage to cancer cells has occurred.
Dr Rebecca Marlow’s photograph: Proliferating cells in a tumour organoid of triple-negative breast cancer
This image shows tumour organoids of triple-negative breast cancer, a hard-to-treat form of the disease, grown from tissue samples donated by patients.
The nuclei of cells are marked in blue, while the cytoskeleton that helps cells maintain their shape is green. Proliferating cells are pink, where cells in the organoid are growing and dividing.
These eye-catching images illustrate just some of the cutting-edge research being carried out at the ICR, taken using sophisticated equipment purchased thanks to generous donations from our supporters.
From images like these our researchers are gaining unprecedented insights into the mechanisms that drive cancer, and new ways to target the disease to help treat patients.
Dr Chris Bakal, who leads the teams in which Maxine and Patricia work, and is a previous winner of the competition himself, said:
“It is a cancer’s ability to spread round the body which often makes it fatal. It is incredibly valuable to be able to image this process over time to give us the insights into cancer biology that we need to discover new treatments.
“Our winners have used cutting-edge imaging technology to create measurable, single-cell imaging in 3D environments, to provide a vivid picture of exactly how cancer cells metastasise.”
Deciding and planning to go for breast reconstruction options after a mastectomy is a huge emotional journey. With the advent of newer plastic surgery techniques, the results are quite natural and satisfactory. Ideally, a woman should be given a choice among the various reconstruction options.
The process begins by consulting plastic surgeons who specialise in reconstructive techniques. Understanding your option will help you make an informed decision that suits your needs. As many as 30% of women undergo breast reconstruction surgery after a mastectomy.
When it comes to breast reconstructive surgery, there are some options available mimicking the size, shape, and texture of your original breast tissue. Some of them might involve implants while others use grafts from your own body for reconstruction.
Here is a guide about what options are available which will best suit your needs.
This involves placement of saline or saline implants under the muscles in your chest where the breast tissue has been removed. If there is insufficient muscle left after surgery to carry out reconstruction, the surgeon makes use of an inflatable implant that is gradually filled with saline or silicon over time which allows for the skin of the growth to follow.
Suitability: Small breasts and petite frame
Duration: surgery takes around two hours with a recovery time of two weeks
Pros: Can be used for a double mastectomy as this is best known for symmetrical results
Cons: Not suitable if you intend to undergo radiotherapy afterward as hardening may result.
DIEP or TRAM Flap Reconstruction
A DIEP flap involves no muscle and consist of fat, skin and blood vessels cut from lower part of your body and implanted in place of your breast tissue.
This is a flap of rectus abdominis, a muscle from your lower abdomen (6 pack muscle) which could be free or pedicled.
Pros: the result is a breast soft in consistency and feels natural. The operation often lasts a lifetime.
Cons: This type of reconstruction is not possible for candidates already bearing scars on their abdomen from previous surgeries. These can droop over time.
LD Flap Reconstruction
LD stands for latissimus dorsi and is a muscle just below your shoulder blade. For reconstruction, it is brought round under the armpit and put over an implant to make a new breast.
Pros: This surgery is comparatively simpler than a DIEP or TRAM flap and requires lesser recovery time. Higher success rate come from the original blood supply that the flap carries with itself to its grated space.
Cons: people who have thicker or paler skin on their back may not have a colour match on the ventral surfaces of their body, i.e., where the breasts are.
Through strategic investment in research, we support young investigators and scientific leaders, acquire technology at the leading edge of cancer research, ensuring a spirit of innovation and collaboration.