title: Evaluation of fat grafting safety in patients with intraepithelial neoplasia: a matched-cohort study.
abstract: BACKGROUND
  Fat grafting is widely carried out in breast cancer patients to improve quality in breast reconstruction. Recently, in vitro and animal studies have questioned the role of adipose tissues in cancer development.
  
  
  METHODS
  Matched-cohort study. We analysed: (i) 59 intraepithelial neoplasia patients who had undergone lipofilling, with no recurrence between primary surgery and lipofilling. (ii) A control group of 118 matched patients (two controls per lipofilling patient) with the corresponding recurrence-free intervals. Both groups were also matched for main cancer criteria. A local event (LE) was the primary end point, with follow-up starting from the baseline.
  
  
  RESULTS
  Median follow-up was 63 and 66 months from surgery, and 38 and 42 from baseline, for the lipofilling and control groups, respectively; the 5-year cumulative incidence of LE was 18% and 3% (P = 0.02). Ki-67 was the significant factor in univariate survival analysis. A subgroup analysis showed that lipofilling increased the risk of LE in women <50 years, with high grade neoplasia, Ki-67 ≥ 14 or who had undergone quadrantectomy.
  
  
  CONCLUSIONS
  Higher risk of LE was observed in intraepithelial neoplasia patients following lipofilling. Although further studies are required to validate our conclusions, patients belonging to this subgroup should be informed of these results and the potential risks.
authors: Department of Reconstructive Surgery, European Institute of Oncology, Milan, Italy. jean.petit@ieo.it
authors: J Y
authors: JY
authors: Petit
authors: M
authors: M
authors: Rietjens
authors: E
authors: E
authors: Botteri
authors: N
authors: N
authors: Rotmensz
authors: F
authors: F
authors: Bertolini
authors: G
authors: G
authors: Curigliano
authors: P
authors: P
authors: Rey
authors: C
authors: C
authors: Garusi
authors: F
authors: F
authors: De Lorenzi
authors: S
authors: S
authors: Martella
authors: A
authors: A
authors: Manconi
authors: B
authors: B
authors: Barbieri
authors: P
authors: P
authors: Veronesi
authors: M
authors: M
authors: Intra
authors: T
authors: T
authors: Brambullo
authors: A
authors: A
authors: Gottardi
authors: M
authors: M
authors: Sommario
authors: G
authors: G
authors: Lomeo
authors: M
authors: M
authors: Iera
authors: V
authors: V
authors: Giovinazzo
authors: V
authors: V
authors: Lohsiriwat
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000601:surgery*; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000601:surgery*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015187:Lipectomy / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D061214:Patient Safety; D012189:Retrospective Studies; D050151:Subcutaneous Fat / Q000637:transplantation*; D016378:Tissue Transplantation / Q000009:adverse effects / Q000379:methods
keywords: breast cancer; breast reconstruction; ductal carcinoma in situ; fat grafting; intra epithelial neoplasia; lipofilling