Autologous fat grafting has become a widely used treatment in breast reconstruction, although there is an ongoing debate about its oncological safety. In fact, we and others have recently shown that all the components of adipose tissue including mature adipocytes and adipose stem cells contribute to breast cancer progression, results that will be presented here in addition to preclinical studies addressing the safety of fat grafting in mouse models. At clinical levels, 2 extensive reviews of the literature on the subject have been recently published. Although the procedure appears globally safe, both reviews underlined the lack of studies with matched control group and long-term follow-up to provide a definitive conclusion. In the only matched cohort study conducted in Milan, we showed that there was no evidence that fat grafting using the standard Coleman techniques significantly increases the risk of breast cancer recurrence. However, this study underlines a potential risk for patients exhibiting in situ carcinoma—a result that we recently confirmed by a dedicated study. To conclude, both preclinical and clinical studies are needed to definitively assess the risk of breast cancer recurrence associated with fat grafting. Two questions that are discussed here appear of importance. Would the results that we obtained with in situ carcinomas be confirmed by other studies? What would be the effect of fat enrichment with adipose stem cells on tumor recurrence?
From the *Université de Toulouse, Toulouse, France; †Institut de Pharmacologie et de Biologie Structurale, Toulouse, France; ‡Department of Endocrine and Breast Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China and §Division of Plastic Surgery, European Institute of Oncology, Milano, Italy.
Received January 17, 2013.
Accepted for publication February 3, 2013.
Address correspondence and reprint requests to Catherine Muller, MD, PhD, IPBS, 205 route de Narbonne, 31077 Toulouse, France; E-mail: email@example.com
Studies performed in our laboratories were supported by the French National Cancer Institute (INCA PL 2006–035 and INCA PL 2010-214 to C.M.), the “Ligue Régionale contre le Cancer” (Comité du Lot, de la Haute-Garonne et du Gers to C.M.), the Fondation de France (to C.M.), and the University of Toulouse (AO CS 2009 to C.M.). Y.Y.W. is a recipient of a doctoral fellowship from the Chinese Research Council.
Presented at the 61 Annual Meeting of the Italian Society of Plastic Surgery (SICPRE), Panel on Lipofilling; Palermo, Italy; September 24–27, 2012.
The authors thank Jamie Brown for the English editing of the manuscript.
The authors report no conflicts of interest.