Lipofilling for Breast Reconstruction After Partial or Total Mastectomy for Breast Cancer Does Not Increase Recurrence Risk

May 6, 2016

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Take-Home Message:

Injection of body fat for refining or creating a reconstructed breast after cancer surgery does not increase the risk of disease recurrence.

 

Summary

Lipofilling of the Breast Does Not Increase the Risk of Recurrence of Breast Cancer: A Matched Controlled Study

Authors: Kronowitz, S.J., Mandujano, C., Liu, J. et al.
Source: Plast Reconstr Surg, 137:385-393, 2016.
journals.lww.com/plasreconsurg/Abstract/2016/02000/Lipofilling_of_the_Breast_Does_Not_Increase_the.1.aspx

Lipofilling is a well-known technique used to refine reconstructed breasts after mastectomy or to refine a breast after lumpectomy. It may also be used to recreate an entire breast following total mastectomy. There have been concerns that the lipoaspirate (the fat cells with their surrounding support structure, neighboring cells and proteins) may contain factors that promote the growth of cancer cells. Therefore, the use of lipofilling after breast cancer surgery has not been advised.

This group searched their institution’s database and identified 719 patients who received lipofilling for reconstruction after breast cancer surgery and 670 patients who did not. These patients’ records were then reviewed for development of breast cancer. The mean follow up time was 5 years. The recurrence rates for the lipofilling and non-lipofilling cases were 1.3% and 2.4%, respectively. This was not a statistically significant difference.

Breast cancer recurrence was equivalent between both groups regardless of cancer stage at operation, location of tumor in the breast, type of mastectomy (partial or total), hormone receptor status, use of chemotherapy or receipt of radiation therapy. The only subgroup with a significant difference in recurrence risk was that of hormone therapy use: patients who received estrogen-receptor directed therapy had a recurrence risk of 1.4% and patients who did not receive such therapy had a risk of 0.5%.

This study supports the use of lipofilling to refine or create a reconstructed breast after cancer surgery.  The risk of cancer recurrence is no higher in these patients than in patients who do not receive lipofilling.  But, the group cautions that special consideration must be given to using the technique in patients receiving hormone therapy.  Although the recurrence risk in that group is quite low, further study should be done to establish the safety of lipofilling for them.