title: The oncologic outcome and immediate surgical complications of lipofilling in breast cancer patients: a multicenter study--Milan-Paris-Lyon experience of 646 lipofilling procedures.
abstract: BACKGROUND
  Lipofilling is now performed to improve the breast contour, after both breast-conserving surgery and breast reconstruction. However, injection of fat into a previous tumor site may create a new environment for cancer and adjacent cells. There is also no international agreement regarding lipofilling after breast cancer treatment.
  
  
  METHODS
  The authors included three institutions specializing in both breast cancer treatment and breast reconstruction (European Institute of Oncology, Milan, Italy; Paris Breast Center, Paris, France; and Leon Berard Centre, Lyon, France) for a multicenter study. A collective chart review of all lipofilling procedures after breast cancer treatment was performed.
  
  
  RESULTS
  From 2000 to 2010, the authors reviewed 646 lipofilling procedures from 513 patients. There were 370 mastectomy patients and 143 breast-conserving surgery patients. There were 405 patients (78.9 percent) with invasive carcinoma and 108 (21.1 percent) with carcinoma in situ. The average interval between oncologic surgical interventions and lipofilling was 39.7 months. Average follow-up after lipofilling was 19.2 months. The authors observed a complication rate of 2.8 percent (liponecrosis, 2.0 percent). Twelve radiologic images appeared after lipofilling in 119 breast-conserving surgery cases (10.1 percent). The overall oncologic event rate was 5.6 percent (3.6 percent per year). The locoregional event rate was 2.4 percent (1.5 percent per year).
  
  
  CONCLUSIONS
  Lipofilling after breast cancer treatment leads to a low complication rate and does not affect radiologic follow-up after breast-conserving surgery. A prospective clinical registry including high-volume multicenter data with a long follow-up is warranted to demonstrate the oncologic safety. Until then, lipofilling should be performed in experienced hands, and a cautious oncologic follow-up protocol is advised.
  
  
  METHODS
  Therapeutic, IV [corrected].
authors.affiliation: Milan, Italy; Paris and Lyon, France; and Bangkok, Thailand From the Division of Plastic and Reconstructive Surgery, European Institute of Oncology; the Paris Breast Center; the Leon Berard Center; and the Department of Surgery, Siriraj Hospital, Mahidol University.
authors.forename: Jean Yves
authors.initials: JY
authors.lastname: Petit
authors.forename: Visnu
authors.initials: V
authors.lastname: Lohsiriwat
authors.forename: Krishna B
authors.initials: KB
authors.lastname: Clough
authors.forename: Isabelle
authors.initials: I
authors.lastname: Sarfati
authors.forename: Tarik
authors.initials: T
authors.lastname: Ihrai
authors.forename: Mario
authors.initials: M
authors.lastname: Rietjens
authors.forename: Paolo
authors.initials: P
authors.lastname: Veronesi
authors.forename: Fabio
authors.initials: F
authors.lastname: Rossetto
authors.forename: Anna
authors.initials: A
authors.lastname: Scevola
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Delay
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D008327:Mammography; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D013524:Surgical Flaps; D013997:Time Factors; D016896:Treatment Outcome