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Fat Grafting after Invasive Breast Cancer: A Matched Case-Control Study

Petit, Jean Yves M.D.; Maisonneuve, Patrick Eng.; Rotmensz, Nicole M.Sc.; Bertolini, Francesco Pr.; Rietjens, Mario Eng.

Plastic & Reconstructive Surgery: June 2017 - Volume 139 - Issue 6 - p 1292–1296
doi: 10.1097/PRS.0000000000003339
Breast: Original Articles
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Discussion

Background: Fat grafting has been widely indicated for postmastectomy and postlumpectomy breast reconstruction. The literature emphasizes the clinical efficacy of fat grafting, but experimental studies raise important questions about the recurrence risk because of the stimulation of remaining cancer cells by progenitor or adult adipocytes. Because breast conservative treatment provides a higher risk of residual cancer cells in the breast tissue compared with mastectomy, the authors set up a matched case-control study of fat grafting versus no fat grafting after breast conservative treatment.

Methods: The authors collected data from 322 consecutive patients operated on for a primary invasive breast cancer who subsequently underwent fat grafting for breast reshaping from 2006 to 2013. All patients were free of recurrence before fat grafting. For each patient, the authors selected one patient with similar characteristics who did not undergo fat grafting.

Results: After a mean follow-up of 4.6 years (range, 0.1 to 10.2 years) after fat grafting, or a corresponding time for controls, the authors observed no difference in the incidence of local events (fat grafting, n = 14; controls, n = 16; p = 0.49), axillary nodes metastasis (fat grafting, n = 3; controls, n = 6; p = 0.23), distant metastases (fat grafting, n = 14; controls, n = 15; p = 0.67), or contralateral breast cancer (fat grafting, n = 4; controls, n = 4; p = 0.51).

Conclusion: Fat grafting seems to be a safe procedure after breast conservative treatment for breast cancer patients.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Milan, Italy

From the Divisions of Plastic and Reconstructive Surgery, Epidemiology and Biostatistics, and Laboratory Haematology-Oncology, European Institute of Oncology.

Received for publication September 26, 2016; accepted November 22, 2016.

A “Hot Topic Video” by Editor-in-Chief Rod J. Rohrich, M.D., accompanies this article. Go to PRSJournal.com and click on “Plastic Surgery Hot Topics” in the “Digital Media” tab to watch. On the iPad, tap on the Hot Topics icon.

Disclosure: The authors have no financial interest to declare in relation to the content of this article.

Jean Yves Petit, M.D., Division of Plastic and Reconstructive Surgery, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy, jean.petit@ieo.it

©2017American Society of Plastic Surgeons