Creation and Implementation a Method for Breast Reconstruction After Radical Surgery Using Decellularized Xenomatrix in Combination With Lymphovenous Anastomosis in Breast Cancer.

According to official statistical data for 2020, 31,505 new cases of cancer were registered in Kazakhstan. Among them, 4,272 were cases of malignant breast neoplasms, making breast cancer the most commonly diagnosed malignancy in the country. This trend has also been observed in previous years, highlighting breast cancer as an important public health concern.

Despite the fact that approximately 94.3% of breast cancer cases are diagnosed at stages I-III, when effective treatment is generally possible, treatment itself remains a significant challenge for patients. Surgical treatment may be associated with delayed complications such as scar contractures and lymphedema. From a psychosocial and quality-of-life perspective, breast loss may significantly affect body image, sense of femininity, psychological well-being, and social reintegration.

In modern breast oncology, immediate breast reconstruction with implants has become an important component of surgical treatment. However, implant-based reconstruction requires reliable fixation and adequate coverage of the implant. Synthetic meshes, including those based on polytetrafluoroethylene and other synthetic polymers, are commonly used for this purpose but may be associated with complications such as reactive inflammation, fibrosis, infection, and implant exposure.

As an alternative to synthetic materials, acellular collagen matrices of animal origin have been introduced into reconstructive breast surgery. These biological materials provide structural support and may facilitate integration with surrounding tissues. However, studies have demonstrated that xenogeneic matrices can differ substantially in their biological behavior depending on their tissue origin and processing methods. In addition, the high cost of commercially available matrices remains a significant limitation to their widespread use.

To address this issue, a group of Kazakhstani researchers developed and patented a domestic wound covering based on acellular bovine peritoneum, known as AXM. The material has demonstrated promising results as a wound covering in preclinical and clinical settings, including applications involving implantation within the body.

However, the use of AXM as a fixation material for breast implants represents a distinct clinical application. Unlike wound coverage, implant fixation requires the matrix to withstand mechanical tension and provide stable long-term support while integrating with the surrounding tissues. Given the differences in the biological and mechanical properties of xenogeneic matrices from different sources, the safety, effectiveness, and reliability of the domestic AXM as a fixation material for breast implants require further clinical evaluation.

Inclusion criteria

• Patients with verified stage I-II breast cancer
• Age 18-65 years
• Absence of accompanying endocrine, cardiovascular, or neurological pathologies in decompensation stage.
• Absence of neurological or psychological deviations affecting capacity.
• Absence of pregnancy
• Absence of HIV, zoonotic infections.
• Absence of allergic reactions to materials or components included in ADM.
• Absence of concomitant oncological diseases, including oncohematological pathology.

Exclusion criteria

• Patients with unverified malignant breast tumors.
• Patients with stage III-IV malignant breast tumors.
• Age under 18 years
• Presence of accompanying endocrine, cardiovascular, or neurological pathologies in decompensation stage.
• Presence of neurological or psychological deviations affecting capacity.
• Pregnancy
• HIV, zoonotic infections.
• Presence of allergic reactions to materials or components included in ADM.
• Presence of concomitant oncological diseases, including oncohematological pathology.
• Intolerance to ADM or its components.
• Medical indications arising during the study.
• Patient non-compliance (failure to comply with postoperative regimen).
• Cessation of therapy for more than 24 hours at the patient's request.
• Non-compliance with participation rules in the study.