title: Clinical and pathologic evaluation of implanted free dermal fat grafts after breast cancer surgery: a retrospective analysis.
abstract: OBJECTIVE
  The efficacy of immediate breast reconstruction using a free dermal fat graft (FDFG) was evaluated clinically.
  
  
  METHODS
  A total of 22 breasts in 21 patients who underwent partial mastectomy for early breast cancer involving mainly the inner upper quadrant were enrolled in this study. The defect was reconstructed immediately by filling it with an autologous FDFG. At 6 months and 1, 2, 3, 4, and 5 years postoperatively, the width (horizontal length) and thickness (distance perpendicular to skin) of the FDFG on computed tomography (CT) scans were measured. Histologic samples from the implanted FDFG were collected by core needle biopsy (CNB). The correlations between clinical findings and volume of the FDFG on CT and the proportion of fatty tissue in the CNB were examined statistically. Cosmetic results were also evaluated.
  
  
  RESULTS
  On CT, the mean width of the FDFG was 95%, 81%, 79%, 73%, 68%, and 47% and the mean thickness were 125%, 121%, 120%, 115%, 104%, and 103% at 6 months, and 1-5 years postoperatively, respectively. In the CNB samples, the mean fatty tissue distribution was 76%, 63%, and 54% at 1 year, 1-4 years, and >4 years postoperatively, respectively. The percent change in the width of the FDFG at 6 months after the operation displayed a significant negative correlation with the postmenopausal period and a significant positive correlation with the maximum surgical margin. On CT, thickness was negatively correlated with the size of the resected breast tissue, and thickness of the implanted FDFG. No clinicopathologic factors or technical factors were related to FDFG outcome and the proportion of fat tissue in the CNB sample, except for axillary dissection. Nineteen of 21 patients had good to excellent cosmesis.
  
  
  CONCLUSIONS
  FDFG implanted into breast defects after partial mastectomy undergo mild resorption and degeneration to fibrous tissue, but most patients have good to excellent cosmesis.
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan. ykijima@m3.kufm.kagoshima-u.ac.jp
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kijima
authors.forename: Heiji
authors.initials: H
authors.lastname: Yoshinaka
authors.forename: Munetsugu
authors.initials: M
authors.lastname: Hirata
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Umekita
authors.forename: Masakazu
authors.initials: M
authors.lastname: Sohda
authors.forename: Chihaya
authors.initials: C
authors.lastname: Koriyama
authors.forename: Tadao
authors.initials: T
authors.lastname: Mizoguchi
authors.forename: Hideo
authors.initials: H
authors.lastname: Arima
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nakajo
authors.forename: Sumiya
authors.initials: S
authors.lastname: Ishigami
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ueno
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008327:Mammography; D015412:Mastectomy, Segmental / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D050507:Subcutaneous Fat, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology / Q000637:transplantation*; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous; D016896:Treatment Outcome