Abstract LB403: Characterizing nanomechanical properties of skin tissue in postmastectomy implant reconstruction

Abstract Introduction: Mastectomy, as treatment or preventative measure for breast cancer, is a critical procedure to reduce breast cancer risk and manage disease. Postmastectomy breast reconstruction (PMBR) aims to restore physical appearance and quality of life but carries significant risks (e.g. 20% chance of implant failure) particularly following postmastectomy radiation therapy. While radiation exposure, obesity, and diabetes are known contributors, currently there are no predictors of implant failure, underscoring a crucial gap in clinical decision-making. This study investigates the role of nanomechanical properties of skin and scar tissues in patients undergoing PMBR. Methods: This research is part of the EMPOWER study (NCT06584396), a single-center, prospective, observational trial at MD Anderson Cancer Center (MDACC), including female patients undergoing preventive or curative mastectomy who opted for tissue expander-based reconstruction. Since the study start in 2023, 95 eligible patients have been enrolled, with 61 patients (131 samples) successfully measured. During expander-to-implant replacement surgeries, plastic surgeons collect skin and fibrous capsule samples containing scar tissue, then resized by MDACC pathologists and analyzed using the ARTIDIS ART-1 Nanomechanical Phenotype System. This system provides nanoscale-resolution spatial analysis of tissue mechanical parameters, generating over 10,000 data points per sample. Nanomechanical profiling is combined with histopathological annotations, and primary endpoints are clinical outcomes (e.g. implant loss) and patient-reported outcomes assessed using the BREAST-Q survey at multiple time points. Results: Initial analysis of stiffness, adhesion, and dissipation data revealed clear nanomechanical signature differences between skin and scar tissue, with scarred areas characterized by incomplete extracellular matrix (ECM) remodeling and disorganization, and non-scarred areas being driven by ECM maturity and deeper skin characteristics. These findings underscore the precision of tissue collection methods and ARTIDIS' ability to differentiate closely located, but functionally different tissue types. Conclusions: This study provides the clinical first evidence of physical tissue characterization as a potential predictor of clinical outcomes in the context of post-mastectomy implant-based reconstruction. These findings lay the groundwork for developing nanomechanical signatures as clinical biomarkers to predict implant failure, improve preoperative risk stratification, and enhance clinical decision-making. Citation Format: Papa Diogop Ndiaye, Mark V. Schaverien, Victor J. Hassid, Paul L. Shay, John W. Shuck, Mark W. Clemens, Jessie Z. Yu, Austin Y. Ha, Gregory Reece, Margaret J. Roubaud, Alexander F. Mericli, Mark T. Villa, Ashleigh M. Francis, David M. Adelman, Donald Baumann, Joani M. Christensen, Ryan M. Dickey, Philip Hanwright, Sahil K. Kapur, Johnathan B. Olenczak, Aysegul A. Sahin, Edna Paredes, Ahmed Jizawi, Gitika Srivastava, Tobias Appenzeller, Sara Nizzero, Marko Loparic, Marija Plodinec, Benjamin D. Smith. Characterizing nanomechanical properties of skin tissue in postmastectomy implant reconstruction [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_2):Abstract nr LB403.