Local‐regional recurrence risk after autologous fat grafting in breast cancer patients: A systematic review and meta‐analysis

Wang, Ke; Dai, Yuechu; Yin, Peng; Cheng, Pu; Jin, Xingming

doi:10.1002/jso.25829

Cited by 11 publications

(3 citation statements)

References 22 publications

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“…[21][22][23] Several meta-analyses in the past 10 years have similarly found no significant increase in locoregional recurrence after fat grafting for breast reconstruction. 24,25 With respect to metastasis, many groups have compared oncological events in patients undergoing autologous fat grafting and nonexposed control patients from the same institution and demonstrated no significant increase risk. [26][27][28] Additional cohort-matched studies have provided a higher level of evidence, suggesting no increased risk for metastasis or mortality after autologous fat grafting.…”

Section: Discussionmentioning

confidence: 99%

“…Large cohort-matched studies with long-term follow-up showed no difference in locoregional recurrence between those who did and did not undergo fat grafting 21–23 . Several meta-analyses in the past 10 years have similarly found no significant increase in locoregional recurrence after fat grafting for breast reconstruction 24,25 . With respect to metastasis, many groups have compared oncological events in patients undergoing autologous fat grafting and nonexposed control patients from the same institution and demonstrated no significant increase risk 26–28 .…”

Section: Discussionmentioning

confidence: 99%

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Oncological Safety of Autologous Fat Grafting for Breast Reconstruction

Strong,

Syrjamaki,

Kamdar

et al. 2024

Ann Plast Surg

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Background Autologous fat grafting has become a vital component of breast reconstruction. However, concerns remain regarding the safety of fat grafting after oncological resection and breast reconstruction. The purpose of the study was to evaluate the association of fat grafting after breast reconstruction with metastasis and death in breast cancer patients. Methods A retrospective, population-based cohort study was conducted using deidentified claims data from 2001 to 2018 and included privately insured patients with breast cancer who underwent breast reconstruction after surgical resection. Breast reconstruction patients who underwent fat grafting were compared with those not undergoing fat grafting, evaluating metastasis and death up to 15 years after reconstruction. One-to-one propensity score matching was used to account for selection bias on patient risk factors comparing those with and without fat grafting. Results A total of 4709 patients were identified who underwent breast reconstruction after lumpectomy or mastectomy, of which 368 subsequently underwent fat grafting. In the propensity score–matched patients, fat grafting was not associated with an increased risk of lymph node metastasis (9.7% fat-grafted vs 11.4% in non–fat-grafted, P = 0.47) or distant metastasis (9.1% fat-grafted vs 10.5% in non–fat-grafted, P = 0.53). There was no increased risk of all-cause mortality after fat grafting for breast reconstruction (3.9% fat-grafted vs 6.6% non–fat-grafted, P = 0.10). Conclusions Among breast cancer patients who subsequently underwent fat grafting, compared with no fat grafting, no significant increase was observed in distant metastasis or all-cause mortality. These findings suggest that autologous fat grafting after oncologic resection and reconstruction was not associated with an increased risk of future metastasis or death.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Oncological Safety of Autologous Fat Grafting for Breast Reconstruction

Strong,

Syrjamaki,

Kamdar

et al. 2024

Ann Plast Surg

View full text Add to dashboard Cite

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“…Countless clinical reviews have been written to assess the oncologic safety of autologous fat transfer, defending its role in breast reconstruction. 25–32 A review by De Decker et al was unable to demonstrate an increased likelihood of developing local recurrence. 33 Another one by Waked et al concluded that there are various tumorigenic adipokines that could initiate tumor growth, but they could not establish a significant adverse outcome of autologous fat transfer.…”

Section: Discussionmentioning

confidence: 99%

Oncologic Outcome of 1000 Postmastectomy Breast Reconstructions with Fat Transfer: A Single-Center, Matched Case-Control Study

Sorotos

Paolini

D’Orsi

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Autologous fat transfer has an important role in breast reconstructive surgery. Nevertheless, some concerns remain with regard to its oncologic safety. The authors present a single-center, case-matching study analyzing the impact of autologous fat transfer in the cumulative incidence of local recurrences. Methods: From a prospectively maintained database, the authors identified 902 patients who underwent 1025 breast reconstructions from 2005 to 2017. Data regarding demographics, tumor characteristics, surgery details, and follow-up were collected. Exclusion criteria were patients with distant metastases at diagnosis, recurrent tumor, or incomplete data regarding primary tumor; and patients who underwent prophylactic mastectomies and breast-conserving operations. Statistical analysis was conducted to evaluate the impact of the variables on the incidence of local recurrence. A value of p < 0.05 was considered statistically significant. Results: After 1:n case-matching, we selected 919 breasts, of which 425 patients (46.2 percent) received at least one autologous fat transfer session versus 494 control cases (53.8 percent). Local recurrences had an overall rate of 6.8 percent, and we found local recurrences in 14 autologous fat transfer cases (3.0 percent) and 54 controls (9.6 percent). Statistical analysis showed that autologous fat transfer did not increase the risk of local recurrences (hazard ratio, 0.337; CI, 0.173 to 0.658; p = 0.00007). Multivariate analysis identified invasive ductal carcinoma subtype and lymph node metastases to have an increased risk of local recurrences (hazard ratio >1). Conversely, positive hormonal receptor status was associated with a reduced risk of events (hazard ratio <1). Conclusions: Autologous fat transfer was not associated with a higher probability of locoregional recurrence in patients undergoing breast reconstruction; therefore, it can be safely used for total breast reconstruction or aesthetic refinements. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.

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