title: Oncological outcomes of lipofilling breast reconstruction: 195 consecutive cases and literature review.
abstract: BACKGROUND
  Lipofilling has become a widely used procedure in breast reconstruction after mastectomy or breast-conserving treatment. The possibility that this technique may increase stimulation of cancer development between the potential tumor bed and the lipoaspirates grafts has been raised regarding its safety. The aim of this study was to identify the oncological risks associated with this procedure in our institution.
  
  
  METHODS
  Between years 2007 and 2014 we record 195 consecutive patients with fat grafting technique for reconstructive purpose after breast cancer treatment. The loco-regional recurrence (LRR) as first event of relapse was the primary end point of this study.
  
  
  RESULTS
  We performed 319 lipofilling procedures in 132 mastectomy and 63 breast-conserving surgery patients. Invasive carcinoma represents 81.6% of the series. The median follow-up from primary cancer surgery and fat grafting was 74 and 31 months respectively. Median time between oncologic surgery and lipofilling was 36 months. The authors observed a complication rate of 8.2%, most of them liponecrosis and oil cysts (7.2%). Four local, 2 regional and 4 distant recurrences were observed as first event of relapse in 10 patients with invasive ductal carcinoma. The loco-regional recurrence rate was 3.1% (1.08% per year).
  
  
  CONCLUSIONS
  Although larger prospective trials are needed, these results support the fact that lipofilling following breast cancer treatment leads to a very low rate of complications and similar to other authors, it does not seem to interfere in patient's oncological prognosis when compared with prior publications.
authors.affiliation: Universitat Autònoma de Barcelona, Department of Surgery, Barcelona, Spain; Plastic and Reconstructive Surgery Service, Hospital Clínic Barcelona, Spain. Electronic address: csilvav@gmail.com.
authors.forename: Claudio
authors.initials: C
authors.lastname: Silva-Vergara
authors.affiliation: Plastic and Reconstructive Surgery Service, Hospital Clínic Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Fontdevila
authors.affiliation: Plastic and Reconstructive Surgery Service, Hospital Clínic Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Descarrega
authors.affiliation: Universitat Autònoma de Barcelona, Department of Surgery, Barcelona, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Burdio
authors.affiliation: Plastic and Reconstructive Surgery Service, Hospital Clínic Barcelona, Spain.
authors.forename: Tai-Sik
authors.initials: TS
authors.lastname: Yoon
authors.affiliation: Universitat Autònoma de Barcelona, Department of Surgery, Barcelona, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Grande
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome
keywords: Breast cancer; Breast reconstruction; Fat graft; Lipofilling