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Fat Graft Safety after Oncologic Surgery

Addressing the Contradiction between In Vitro and Clinical Studies

Orbay, Hakan, M.D., Ph.D.; Hinchcliff, Katharine M., M.D.; Charvet, Heath J., M.D.; Sahar, David E., M.D.

Plastic and Reconstructive Surgery: December 2018 - Volume 142 - Issue 6 - p 1489–1499
doi: 10.1097/PRS.0000000000004992
Experimental
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Background: The authors investigate the in vitro and in vivo interaction of human breast cancer cells and human adipose-derived stem cells to address the controversy on the safety of postmastectomy fat grafting.

Methods: The authors co-cultured human adipose-derived stem cells and MDA-MB-231 breast cancer cells in an in vitro cell migration assay to examine the migration of breast cancer cells. In the in vivo arm, the authors injected breast cancer cells (group I), human breast cancer cells plus human adipose-derived stem cells (group II), human breast cancer cells plus human fat graft (group III), and human breast cancer cells plus human fat graft plus human adipose-derived stem cells (group IV) to the mammary fat pads of female nude mice (n = 20). The authors examined the tumors, livers, and lungs histologically after 2 weeks.

Results: Migration of breast cancer cells increased significantly when co-cultured with adipose-derived stem cells (p < 0.05). The tumor growth rate in group IV was significantly higher than in groups I and II (p < 0.05). The tumor growth rate in group III was also higher than in groups I and II, but this difference was not statistically significant (p > 0.05). Histologically, there was no liver/lung metastasis at the end of 2 weeks. The vascular density in the tumors from group IV was significantly higher than in other groups (p < 0.01).

Conclusion: The injection of breast cancer cells, fat graft, and adipose-derived stem cells together increases breast cancer xenograft growth rates significantly.

Patient Safety CME.

Sacramento, Calif.

From the Department of Surgery, Division of Plastic Surgery, University of California, Davis Medical Center.

Received for publication March 2, 2017; accepted April 19, 2018.

Presented at the 61st Annual Meeting of the Plastic Surgery Research Council, in New York, New York, May 19 through 22, 2016; and the 14th Annual International Conference of the International Federation for Adipose Therapeutics and Science, in San Diego, California, November 17 through 20, 2016.

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

Supplemental digital content is available for this article. Direct URL citations appear in the text; simply type the URL address into any Web browser to access this content. Clickable links to the material are provided in the HTML text of this article on the Journal’s website (www.PRSJournal.com).

By reading this article, you are entitled to claim one (1) hour of Category 2 Patient Safety Credit. ASPS members can claim this credit by logging in to PlasticSurgery.org Dashboard, clicking “Submit CME,” and completing the form.

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.

Hakan Orbay, M.D., Ph.D., Division of Plastic Surgery, University of California, Davis Medical Center, 4625 2nd Avenue, Room 3001, Sacramento, Calif. 95817, horbay@ucdavis.edu

©2018American Society of Plastic Surgeons