Breast-Conserving Surgery with Immediate Autologous Fat Grafting Reconstruction: Oncologic Outcomes

Biazús, Jorge Villanova; Stumpf, Camile Cesa; Melo, Márcia Portela de; Zucatto, Ângela Erguy; Cericatto, Rodrigo; Cavalheiro, José Antônio Crespo; Damin, Andréa Pires Souto

doi:10.1007/s00266-018-1155-5

Cited by 25 publications

(17 citation statements)

References 18 publications

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“…reported in previous studies [10,17,23,36]. Different patient populations, excision extensions, ap sizes, and donor sites might lead to this difference.…”

Section: Discussionmentioning

confidence: 85%

“…Various studies [9][10][11][12][13] have shown that immediate autologous breast reconstruction (IABR), including autologous fat grafting and myocutaneous ap transfer, is an alternative method for some patients who received BCS, with better aesthetic results and safety, lower rates of surgical complications, and higher overall survival rates compared with traditional BCS or implant-based reconstruction. Additionally, IABR has other advantages over delayed reconstruction such as a shorter total operative time, less scarring, and decreased psychological distress for the patients [14,15].…”

Section: Introductionmentioning

confidence: 99%

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Short-term Outcomes and Safety of Radiotherapy for Immediate Breast Reconstruction with Autologous Flap Transfer Following Breast-conserving Surgery

Zhang

Song

Wang

et al. 2020

Preprint

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Background: The outcomes of immediate autologous breast reconstruction (IABR) after partial mastectomy followed by postoperative radiotherapy (RT) in terms of aesthetics, treatment-related complications, and local control are unclear. In this study, we evaluated the efficacy of IABR after partial mastectomy with or without breast RT, and thus the impact of radiation on autologous flap transfer.Method: A retrospective cohort study involving consecutive breast cancer patients who underwent IABR after partial mastectomy between July 2011 and December 2017 at Shengjing Hospital was performed. Patients were divided into two groups based on whether or not they received RT after IABR. We compared aesthetic outcomes and changes in the flap size over the three-dimensional coordinates at various timepoints (pre-RT, 1, 6, and 12 months post-RT), as well as postoperative complications, survival, and recurrence rates between the two groups. Results: No significant difference was found in the rate of regional recurrence between the two groups (3.13% vs. 3.85%, P=1.00), and no local recurrences occurred in either group. At the timepoints pre-RT, 1, and 6 months post-RT (approximately 4, 7, and 12 months after IABR, respectively), 77 (91.7%), 70 (83.3%), and 83 (98.8%) patients, respectively, had achieved very good or good cosmetic outcomes, and only changes in breast skin color at 1 month after RT (7 months after IABR) significantly differed between the RT and non-RT groups, with very good or good cosmetic result rates of 62.5% vs. 96.2%, respectively (P<0.001). No significant difference in the reduction of flap size was observed at any timepoint between the RT and non-RT groups. The flap size was significantly reduced at 4 months after IABR compared with the initial size during surgery, and then tended to be stable in both groups. There were no significant differences between the two groups in the rates of postoperative complications including necrosis of the flap, infection, hematoma, or seroma (all P>0.05). Finally, no grade 3 or greater RT-associated adverse events occurred during or after RT.Conclusion: RT following IABR provides aesthetically satisfactory results without intolerable adverse complications and may safely be performed in patients who underwent IABR after partial mastectomy.

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“…reported in previous studies [10,17,23,36]. Different patient populations, excision extensions, ap sizes, and donor sites might lead to this difference.…”

Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Short-term Outcomes and Safety of Radiotherapy for Immediate Breast Reconstruction with Autologous Flap Transfer Following Breast-conserving Surgery

Zhang

Song

Wang

et al. 2020

Preprint

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“…Sample size could not be predicted due to the slow flow of cases and the limitation of the inclusion criteria for only cases had mass of <50 mm and this was the trend for multiple studies tried a new procedure. [15][16][17][18] Obtained data were presented as mean, standard deviation, numbers and percentages. Results were analyzed using paired t-test for analysis within each group.…”

Section: Discussionmentioning

confidence: 99%

Autologous breast fibrofatty flaps for immediate breast reconstruction after excision of small cancer mass (<50 mm) improves surgical and aesthetical outcomes and patients’ quality of life

Shoda

Wahab²

2020

Int Surg J

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Background: Evaluation of surgical feasibility, aesthetic outcomes and 6-m postoperative (PO) effect of immediate breast reconstruction (IBR) using autologous fibrofatty flaps after localized small breast mass excision.Methods: Total 29 women had duct carcinoma of <50 mm in diameter with N1-3 regional lymphadenopathy were studied. Through diamond-shape incision, breast gland was removed with 1 cm circumferential free safety margin, then the medial and lateral fibrofatty flaps were undermined and approximated for IBR. Breast measurements; the nipple-to-suprasternal notch distance and the nipple-to-nipple distance were determined preoperatively and 6-m PO. Quality of life (QoL) evaluation was performed preoperatively and 6-m PO using the short-form-36 (SF-36), the multidimensional body self-relations questionnaire appearance assessment and the European organization for research and treatment of cancer breast cancer-specific QoL questionnaire scores in breast cancer. Results: Mean operative time was 94.5±15.4 min; mean intraoperative blood loss was 170.1±34.9 ml and 25 patients had returned home on the same operative day. Two patients had PO wound seroma and one patient had wound hematoma, but were resolved spontaneously. PO breast measurements showed non-significant differences in comparison to preoperative measurements of the same breast, and to measurements of the contralateral breast. PO evaluation of QoL showed significantly improved PO scoring in line with improved body image and future perspectives, and sexual scores in comparison to preoperative scorings. Conclusions: The applied procedure of localized excision of BC mass of<50 mm with IBR using the breast remnant fibrofatty flaps provided acceptable surgical and esthetical outcomes and allowed improvement of patients’ QoL.

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“…40 Similarly, fat grafting has been reported as an adjunct therapy performed concomitantly with other common breast surgeries, including mastopexy and reduction mammoplasty, to enhance aesthetic results and overall patient satisfaction following these procedures. [41][42][43][44]…”

Section: Applications Of Fat Grafting In Aesthetic Breast Surgerymentioning

confidence: 99%

Application of Fat Grafting in Cosmetic Breast Surgery

Davis

Perdanasari

Abu‐Ghname

et al. 2020

Seminars in Plastic Surgery

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The role of fat grafting to the breasts has evolved in the recent past, gaining several new applications within both reconstructive and aesthetic surgery. Initially used for reconstructive purposes to fill lumpectomy defects or to correct residual contour deformities after breast reconstruction, it has since made its way into cosmetic breast surgery and has grown to encompass a wide variety of new indications. Fat grafting in aesthetic breast surgery may be performed as a form of primary autologous breast augmentation or as an adjunct to implant-based breast augmentation to disguise implant edges. It may also be used to provide added volume after explant surgery or to provide improvements in breast contour alongside mastopexy techniques. In this article, we will review the current applications of fat grafting in aesthetic breast surgery and provide an up-to-date summary of its reported outcomes, safety, and complications.

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Breast-Conserving Surgery with Immediate Autologous Fat Grafting Reconstruction: Oncologic Outcomes

Abstract: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cited by 25 publications

References 18 publications

Short-term Outcomes and Safety of Radiotherapy for Immediate Breast Reconstruction with Autologous Flap Transfer Following Breast-conserving Surgery

Short-term Outcomes and Safety of Radiotherapy for Immediate Breast Reconstruction with Autologous Flap Transfer Following Breast-conserving Surgery

Autologous breast fibrofatty flaps for immediate breast reconstruction after excision of small cancer mass (<50 mm) improves surgical and aesthetical outcomes and patients’ quality of life

Application of Fat Grafting in Cosmetic Breast Surgery

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