The representation of the breast on the somatosensory cortex after autologous breast reconstruction using 7 Tesla functional MRI

To study the effects of mastectomy and autologous breast reconstruction on the
sensation of the (reconstructed) breast, not only the peripheral reinnervation
of the breast should be studied, but also the changes that take place in the
somatosensory cortex. The sensation of the reconstructed breast has been
studied previously, but the neuroplasticity of the brain, or the ability of the
brain to change after - in this case - breast surgery, remains unknown.
Recently, a pilot study with healthy subjects has been conducted to localize
the sensation of the breast on the somatosensory cortex using 7 Tesla
functional MRI imaging. Now that the region of interest in the brain and the
somatotopy of the non-operated breast are known, studies with patients who
underwent mastectomy and breast reconstruction are the next step to understand
the neuroplasticity of the brain following breast surgery.

To study the neuroplasticity of the brain after mastectomy and breast
reconstructive surgery by assessing the somatotopy of the breast on the
somatosensory cortex of patients who underwent either breast reconstruction
with and without nerve restoration or mastectomy without breast reconstruction.

A single center imaging study carried out in MUMC+. Every subject will undergo
a single functional MRI scan in the 7 Tesla MRI scan of Scannexus at least six
months after the operation. A scanning session takes approximately 75 minutes.
During the scan, piezo-electric stimulators are applied to both the
reconstructed and non-operated breast in a fixed pattern. These stimulators
stimulate the skin and sensory nerves of the breast and nipple-areola complex
in a random sequence.

All subjects are recruited by their treating physicians at the outpatient
clinic of plastic surgery and surgical oncology or by means of a recruitment
letter on behalf of the treating physician. Patients are informed about the
study and the procedures, and the subject information and consent form are
handed out. If patients are willing to participate, an appointment is made with
the researcher to sign the consent form, fill out the CRF and schedule the MRI
scan. On a later moment every subject will undergo a single functional MRI scan
taking 75 minutes. There are no follow-up moments. Subjects do not have any
direct benefits in participating in the study. In the rare case an anomaly is
identified on any of the fMRI images, this will be discussed with the subject
and this information is shared with the general practitioner. Subjects who are
willing to participate in the study, accept the fact that stimulators are
applied on a bare breast to stimulate the skin and nipple-areola complex. The
burden associated with participation in this study, involves the usual MRI side
effects (e.g. anxious or claustrophobic feelings) and a possible adverse skin
reaction to adhesives upon applying the stimulators. No radiation is involved.