title: Fat grafting for alleviating persistent pain after breast cancer treatment: A randomized controlled trial.
abstract: BACKGROUND
  Persistent pain is a common side effect of breast cancer treatment, affecting 24-52% of women after mastectomy. Recent studies have described analgesic effects of fat grafting in various settings. We aimed to investigate whether fat grafting had an analgesic effect on persistent pain after mastectomy and whether fat grafting had a remodeling effect on the mastectomy scar.
  
  
  METHODS
  This study was conducted as a randomized controlled trial. Patients were randomized to either receive fat grafting to the pain-afflicted area around the missing breast or a control group without any intervention. A total of 18 unilaterally mastectomized women with persistent pain ≥3 on the numerical rating scale were enrolled. Patients were examined at the baseline and at 3 and 6 months by using the DoloTest(®), visual analog scale (VAS) pain score, neuropathic pain symptom inventory, and patient and observer scar assessment scale.
  
  
  RESULTS
  A total of 15 patients were analyzed (fat grafted n = 8, control n = 7). The average amount of grafted fat was 71 ± 24.6 mL. Fat grafting showed a significant improvement in the pain as measured on the VAS pain scale (p = 0.001) with an average reduction of 54.9% and as measured on the neuropathic pain symptom inventory (p = 0.002). Furthermore, a significant improvement was observed in health-related quality of life (p = 0.007) and the quality of the scar (p < 0.001).
  
  
  CONCLUSIONS
  This is the first randomized controlled trial evaluating the analgesic effect of fat grafting. Fat grafting is a safe and effective technique for alleviating persistent pain after mastectomy.
authors.affiliation: Plastic Surgery Research Unit, Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, Denmark. Electronic address: alexander@oncology.dk.
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Juhl
authors.affiliation: Danish Pain Research Center, Aarhus University Hospital, Aarhus, Denmark; Stereology and Electron Microscopy Laboratory, Aarhus University Hospital, 44 Nørrebrogade, 8000, Aarhus C, Denmark.
authors.forename: Páll
authors.initials: P
authors.lastname: Karlsson
authors.affiliation: Plastic Surgery Research Unit, Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Tine E
authors.initials: TE
authors.lastname: Damsgaard
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy / Q000009:adverse effects*; D008875:Middle Aged; D009437:Neuralgia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011788:Quality of Life; D012086:Reoperation; D016896:Treatment Outcome; D055815:Young Adult
keywords: Breast cancer; Fat grafting; Neuropathic pain symptom inventory; Persistent pain; Randomized controlled trial