title: Immediate breast reconstruction using autologous free dermal fat grafts provides better cosmetic results for patients with upper inner cancerous lesions.
abstract: OBJECTIVE
  Although breast-conserving therapy (BCT) is the standard form of treatment for early-stage breast cancer, in patients with small breasts cosmetic results can be poor, especially when the lesion is located on the inner upper quadrant area. This study analyzes our use of autologous free dermal fat grafts (FDFGs) for immediate breast reconstruction.
  
  
  METHODS
  A total of 23 patients who received a partial mastectomy for an inner upper quadrant lesion from 1992 to 2006 at Kagoshima University Hospital were retrospectively divided into three groups according to the reconstructive procedure that was used for the defect after partial mastectomy: immediate reconstruction using an autologous FDFG from the lower abdomen (group FDFG); patients receiving only rotation and fixation of the parenchymal adipose tissue or gland to repair the defect (group GL); and a third group who underwent immediate reconstruction using a miniflap of the latissimus dorsi (group LD).
  
  
  RESULTS
  The total duration of surgery in group FDFG was significantly shorter than in group LD (P < 0.01). The mean volume of blood lost in group FDFG was significantly lower than in group LD (P < 0.01). The breast retraction assessment (BRA) of group FDFG was significantly better than for the patients in groups GL and LD (P < 0.01). The total score using the ABNSW system for cosmetic assessment was significantly better in group FDFG than in group GL (P < 0.01). Similarly, the total score in group FDFG using the assessment by the Japanese Breast Cancer Society was significantly higher than that in group GL (P < 0.01).
  
  
  CONCLUSIONS
  Immediate breast reconstruction for a defect after a partial mastectomy of an upper inner quadrant malignant lesion using FDFG can be especially useful for patients with small breasts.
authors: Department of Surgical Oncology, Breast and Endocrine Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
authors: Yuko
authors: Y
authors: Kijima
authors: Heiji
authors: H
authors: Yoshinaka
authors: Yawara
authors: Y
authors: Funasako
authors: Koichi
authors: K
authors: Kaneko
authors: Munetsugu
authors: M
authors: Hirata
authors: Tadao
authors: T
authors: Mizoguchi
authors: Sumiya
authors: S
authors: Ishigami
authors: Hideo
authors: H
authors: Arima
authors: Akihiro
authors: A
authors: Nakajo
authors: Shinichi
authors: S
authors: Ueno
authors: Shoji
authors: S
authors: Natsugoe
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D004954:Esthetics; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D016462:Mammaplasty / Q000379:methods*; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000601:surgery* / Q000628:therapy; D012086:Reoperation; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D014182:Transplantation, Autologous; D016896:Treatment Outcome