title: Prospective trial of adipose-derived regenerative cell (ADRC)-enriched fat grafting for partial mastectomy defects: the RESTORE-2 trial.
abstract: OBJECTIVE
  Women undergoing breast conservation therapy (BCT) for breast cancer are often left with contour defects and few acceptable reconstructive options. RESTORE-2 is the first prospective clinical trial using autologous adipose-derived regenerative cell (ADRC)-enriched fat grafting for reconstruction of such defects. This single-arm, prospective, multi-center clinical trial enrolled 71 patients post-BCT with defects ≤150 mL.
  
  
  METHODS
  Adipose tissue was collected via syringe lipoharvest and then processed during the same surgical procedure using a closed automated system that isolates ADRCs and prepares an ADRC-enriched fat graft for immediate re-implantation. ADRC-enriched fat graft injections were performed in a fan-shaped pattern to prevent pooling of the injected fat. Overall procedure times were less than 4 h. The RESTORE-2 protocol allowed for up to two treatment sessions and 24 patients elected to undergo a second procedure following the six month follow-up visit.
  
  
  RESULTS
  Of the 67 patients treated, 50 reported satisfaction with treatment results through 12 months. Using the same metric, investigators reported satisfaction with 57 out of 67 patients. Independent radiographic core laboratory assessment reported improvement in the breast contour of 54 out of 65 patients based on blinded assessment of MRI sequence. There were no serious adverse events associated with the ADRC-enriched fat graft injection procedure. There were no reported local cancer recurrences. Injection site cysts were reported as adverse events in ten patients.
  
  
  CONCLUSIONS
  This prospective trial demonstrates the safety and efficacy of the treatment of BCT defects utilizing ADRC-enriched fat grafts.
authors.affiliation: Hospital General Universitario Gregorio Maranon, Madrid, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Pérez-Cano
authors.forename: J J
authors.initials: JJ
authors.lastname: Vranckx
authors.forename: J M
authors.initials: JM
authors.lastname: Lasso
authors.forename: C
authors.initials: C
authors.lastname: Calabrese
authors.forename: B
authors.initials: B
authors.lastname: Merck
authors.forename: A M
authors.initials: AM
authors.lastname: Milstein
authors.forename: E
authors.initials: E
authors.lastname: Sassoon
authors.forename: E
authors.initials: E
authors.lastname: Delay
authors.forename: E M
authors.initials: EM
authors.lastname: Weiler-Mithoff
mesh_terms: D017667:Adipocytes / Q000637:transplantation*; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000601:surgery; D005260:Female; D006801:Humans; D007267:Injections; D016462:Mammaplasty / Q000379:methods*; D015412:Mastectomy, Segmental / Q000009:adverse effects*; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods; D008875:Middle Aged; D011446:Prospective Studies; D050151:Subcutaneous Fat / Q000166:cytology / Q000637:transplantation*; D016896:Treatment Outcome