Models for Implant-Induced Capsular Contracture Post Breast Cancer Surgery

Abstract

Capsular contracture is a painful deformation of scar-tissue that may form around an implant in post-breast cancer reconstruction or cosmetic surgery. Inflammation due to surgical trauma or contamination in the tissue around the implant could account for recruitment of immune cells, and transdifferentiation of resident fibroblasts into cells that deposit abnormally thick collagen. Here we examine this hypothesis using a mathematical model for interacting macrophages, fibroblasts, myofibroblasts, and collagen. Our model demonstrates that cellular response can, together with inflammatory cell recruitment, account for prognoses.

Implant Texture and Capsular Contracture: A Review of Cellular and Molecular Pathways

“…A model can probe specific hypotheses for causal factors. 61 For example, one hypothesis posits that increased inflammation elevates the risk of CC. However, is inflammation enough, on its own, to do so, or are there important feedback loops that could be targeted by drugs to ameliorate the outcome?…”

“…A model can unravel the distinct roles of intrinsic (genetic and physiological) parameters, versus stimuli or insults that put an otherwise healthy patient on a trajectory towards CC. 61 Although mathematical models can help our understanding of CC etiopathogenesis, further quantitative and qualitative observations on which to base model hypotheses are needed. 14 While no single model is "the truth," exploring a suite of hypotheses using model-based arguments is significantly simpler, faster, and cheaper than costly experimental studies or clinical trials.…”

“…Models have been applied to explore the roles of macrophages, myofibroblasts, 14 and collagen 59 in wound contraction, and recently, in CC. 61 So far, the effects of surface implant texture and cell-to-cell forces 56,57,60 are yet to be modeled, one of our current goals.…”