title: Immediate lipofilling in breast conserving surgery.
abstract: BACKGROUND
  The aim of breast conserving surgery (BCS) is to excise the cancer with clear margins whilst at the same time leaving a good or excellent cosmetic result. A significant percentage of women, who have large cancers or have limited breast volumes, achieve poor cosmetic outcomes. BCS with immediate volume replacement using lipofilling or autologous fat transfer is a new technique. The aim of this study was to evaluate the cosmetic outcomes of a pilot study of patients having BCS and immediate lipofilling performed in The Edinburgh Breast Unit.
  
  
  METHODS
  Questionnaires were mailed to 35 women who had BCS with immediate lipofilling and completed by 32 and results compared with those from a contemporary series of 39 women who had BCS alone. The cancers were significantly larger in the lipofilling group (median 21 mm vs. 16 mm p = 0.011) and the patients were non-significantly younger (median age 49 years vs. 54 p = 0.06).
  
  
  RESULTS
  At a median follow-up of 36 months, results from the Breast Q™ questionnaire showed significantly better cosmetic outcomes with lipofilling (most p < 0.001) and less local breast symptoms (p = 0.0045). There have been no local recurrences in either group and only 1 of the 35 patients was recalled following post-operative surveillance annual mammography.
  
  
  CONCLUSIONS
  BCS and immediate lipofilling provides superior cosmetic outcomes to standard BCS.
authors.affiliation: Edinburgh Breast Unit, NHS Lothian, Western General Hospital, Edinburgh, UK. Electronic address: lucykhan@doctors.org.uk.
authors.forename: L R
authors.initials: LR
authors.lastname: Khan
authors.affiliation: Edinburgh Breast Unit, NHS Lothian, Western General Hospital, Edinburgh, UK. Electronic address: cameron.raine@nhslothian.scot.nhs.uk.
authors.forename: C R
authors.initials: CR
authors.lastname: Raine
authors.affiliation: Edinburgh Breast Unit, NHS Lothian, Western General Hospital, Edinburgh, UK. Electronic address: mike.dixon@ed.ac.uk.
authors.forename: J M
authors.initials: JM
authors.lastname: Dixon
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D010865:Pilot Projects; D011795:Surveys and Questionnaires; D014182:Transplantation, Autologous; D016896:Treatment Outcome
keywords: Autologous fat transfer; Breast cancer; Breast conserving surgery; Cosmetic outcome; Lipofilling