Grants Funded

Abstract
Our research is aimed at improving breast cancer treatment and reconstruction. Specifically we are studying the use of fat grafting in re-contouring the breast after cancer resection. Fat grafting for reconstruction is currently in widespread use. This is despite unpredictable results that vary widely among patients. The recent discovery of stem cells in fat, so called adipose-derived stem cells (ADSC), has provided a potential explanation for the varying degrees of fat retention. The objectives of our research project are to investigate factors influencing the survival of grafted fat. This will be accomplished in two parts. First, we will characterize the effect of increasing patient age on ultimate fat graft survival. We will collect demographic data and information regarding previous cancer chemotherapy treatment on patients undergoing fat grafting. Using a 3D camera, patients will undergo volumetric measurements prior to and post-surgery at selected time points (one, three and six-months postoperative). Each patient population will be assessed for a correlation with graft retention. Second, we will categorize patients by percent of graft survival (e.g., >75%, 50-75%, <50%) and assess for a correlation in number of ADSC. We will quantify pre- and post-surgery volumes and group patients by percent of fat graft retention. These groups will be compared by mean number of ADSC. We believe there is a correlation between fat graft retention and fraction of cells capable of differentiation present in each person. Quantifying stem cells will be performed using laboratory methods including cell counts and flow cytometry. Since cellular fraction of stem cells likely decreases with age, we believe increasing patient age is inversely proportional to the amount of fat graft remaining as long-term viable tissue. By defining which patients benefit most from fat grafting, clinicians will be able to properly select patients for this procedure.

Biography
Brian Mailey, MD is a plastic surgery resident at the University of California, San Diego. He received his medical degree from the University of Illinois at Chicago and completed his general surgery training at the University of California, Irvine. During general surgery residency, Dr. Mailey completed a research fellowship under Joseph Kim, MD at the City of Hope Cancer Center. Because of his research, Dr. Mailey received the Merit Award from the American Society of Clinical Oncology and was awarded top resident paper by the Society for Surgery of the Alimentary Tract. To date, Dr. Mailey has authored or co-authored 25 manuscripts and book chapters. Dr. Mailey is a board-certified general surgeon with long-term goals of additional microsurgical training and a career in academia. He developed a research interest in regenerative medicine while working with plastic surgery mentors, Drs. Anne Wallace, Marek Dobke and Steven Cohen. Together their research focuses on correlating stromal vascular fraction with fat graft survival in breast cancer patients.