Oncological safety of autologous fat grafting after breast conservative treatment: a prospective evaluation.
Autologous fat graft to the breast is a useful tool to correct defects after breast conservative treatment (BCT). Although this procedure gains popularity, little is known about the interaction between the fat graft and the prior oncological environment. Evidences of safety of this procedure in healthy breast and after post-mastectomy reconstruction exist. However, there is paucity of data among patients who underwent BCT which are hypothetically under a higher risk of local recurrence (LR). Fifty-nine patients, with prior BCT, underwent 75 autologous fat graft procedures using the Coleman's technique, between October 2005 and July 2008. Follow-up was made by clinical and radiologic examination at least once, after 6 months of the procedure. Mean age was 50 ± 8.5 years, and mean follow-up was 34.4 ± 15.3 months. Mean time from oncological surgery to the first fat grafting procedure was 76.6 ± 30.9 months. Most of patients were at initial stage 0 (11.8%), I (33.8%), or IIA (23.7%). Immediate complication was observed in three cases (4%). Only three cases of true LR (4%) associated with the procedure were observed during the follow-up. Abnormal breast images were present in 20% of the postoperative mammograms, and in 8% of the cases, biopsy was warranted. Autologous fat graft is a safe procedure to correct breast defects after BCT, with low postoperative complications. Although it was not associated with increased risk of LR in the group of patients studied, prospective trials are needed to certify that it does not interfere in patient's oncological prognosis.
Department of Gyanecology and Obstetrics - Breast Oncology Division, State University of Campinas (Unicamp), Campinas - São Paulo, Brazil; Division of Breast Surgery, São José's Hospital, Beneficencia Portuguesa de São Paulo, São Paulo, Brazil.
Fabricio
F
Brenelli
Mario
M
Rietjens
Francesca
F
De Lorenzi
Aarão
A
Pinto-Neto
Fabio
F
Rossetto
Stefano
S
Martella
José R P
JR
Rodrigues
Daniel
D
Barbalho
D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000379:methods; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011446:Prospective Studies; D014182:Transplantation, Autologous / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
adipocyte stem cell; autologous fat graft; breast cancer; breast reconstruction; local recurrence