I think we have found the reason it is not selling from the...

I think we have found the reason it is not selling from the paper.

The potential drawbacks include the inability to remove air from the expander, a relatively larger initial size as compared with saline expanders and the need for radiation oncologists to adjust their protocols to account for the presence of air instead of saline inside the expander. Standard PMRT has been shown not to affect the functionality of the AeroForm tissue expander. Several studies have documented the dosimetric effect of the metallic port found in traditional saline expanders; however, the AeroForm expander is relatively new and published dosimetry studies are limited. Moni et al. found that the presence of CO2 gas and a metallic reservoir did not lead to clinically relevant alterations in dose distribution. Management of adjuvant radiation therapy with this device in place requires modification of standard treatment planning protocols designed to irradiate traditional expanders filled with saline. This has been successfully implemented at multiple centers in Australia and the United States with acceptable dose distribution but concern remains about the effect on long-term outcomes. This has implications in the clinical scenario when neoadjuvant chemotherapy patients need to proceed to radiation quickly after mastectomy and before final implant exchange. Longer term studies are required to evaluate the safety and efficacy of radiation in these patients.

The inability to deflate the expander for radiation is another concern similar to the clinical scenario faced after direct-to-implant breast reconstruction with highly projecting cohesive gel implants. These modern permanent breast implants cannot be taped to the side of the patient like a large native breast. In the case of AeroForm expanders, our current preference is to delay expansion of the contralateral, noncancer side until a decision is made regarding the need for irradiation. This avoids the need for adjusting the tangent beam of irradiation for cross table radiation therapy. The presence of a projecting contralateral breast leads to the potential for incidental irradiation of a healthy breast and increased dose to thoracic organs such as the heart and lungs. This is especially relevant when treating left-sided cancers.

Why this company went all out trying to sell AeroForm before ensuring these questions were answered is beyond incompetence.