Oncological Safety of Autologous Fat Grafting in Breast Reconstruction after Mastectomy for cancer: A case-control study

Berti, Matteo; Goupille, Caroline; Doucet, Michèle; Arbion, Flavie; Vildé, A.; Body, G.; Ouldamer, Lobna

doi:10.1016/j.jogoh.2021.102257

Cited by 8 publications

(4 citation statements)

References 20 publications

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“…In their study, lipofilling wasn’t a predictive factor for recurrence, for overall survival or for distance metastasis. Although women treated for invasive cancer presented an independent predictive factor for local recurrence [P<0.05, hazard ration (HR): 5.06 (1.97–10.6)] ( 29 ). A further retrospective cohort study, involving the examination of 93 women who had undergone autologous fat grafting (AFG) following breast cancer treatment, revealed no discernible difference in tumor recurrence or distant metastases.…”

Section: Discussionmentioning

confidence: 99%

Breast fat grafting and cancer: a systematic review of the science behind enhancements and concerns

Valente,

Ely,

Kieling

et al. 2024

Transl Breast Cancer Res

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Background Autologous fat transfer (AFT) is gaining popularity in breast surgery, offering a natural-looking and minimally invasive approach for augmentation, reconstruction, and contouring. However, concerns about its impact on breast cancer necessitate an understanding of the interplay between transplanted adipose-derived stem cells (ADSCs) and the breast tissue microenvironment. Renowned for regeneration, ADSCs raise questions about their role in cancer promotion. This systematic review delves into the complex relationship between AFT and breast cancer, exploring how ADSCs may influence development, growth, and metastasis. Methods A systematic search of electronic databases, including PubMed, Embase, and BVS was conducted to identify relevant studies. The search strategy employed a combination of keywords, including “breast augmentation”, “fat grafting”, “breast enhancement”, “mammoplasty”, “cancer”, “neoplasm” and related terms. Two reviewers independently screened titles and abstracts. Full-text articles were then retrieved for further evaluation based on their potential contribution to the review objectives. Results Two hundred and forty records were identified. Among these, 104 duplicates were removed, resulting in 136 reports available for title and abstract screening. Subsequently, 54 papers were deemed potentially eligible for inclusion, and all reports were retrieved. Conclusions In vitro studies reveal ADSCs dual role in breast cancer, influencing proliferation, migration, and drug resistance through complex signaling pathways. Animal studies highlight distinct ADSC subpopulations impacting tumor growth via direct interactions and extracellular vesicle cargo. In vivo , ADSC-enriched fat grafting is generally safe, showing no increased cancer recurrence risk compared to other methods. Notably, cases of invasive breast carcinoma warrant special attention. ADSC-enriched fat grafts exhibit potential benefits in graft retention and survival rates. Despite promising evidence, further studies are needed to comprehensively understand the intricate relationship between ADSCs and breast cancer for optimized clinical applications and potential therapeutic innovations.

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Section: Discussionmentioning

confidence: 99%

Breast fat grafting and cancer: a systematic review of the science behind enhancements and concerns

Valente,

Ely,

Kieling

et al. 2024

Transl Breast Cancer Res

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“…23 Numerous studies now prove that this technique is also reliable in terms of carcinology. 6,15,22,25…”

Section: Discussionmentioning

confidence: 99%

“…14 Fat transfers have become essential to improving and finalizing these breast reconstructions. 6,7,15 Implants, which represent more than 70% of reconstructions, have multiple advantages: rapid recovery of breast volume and good quality results; but there are multiple longterm defects including inconsistency, mobility and asymmetry of the reconstructed breast. 16 Flaps do not have these shortcomings and are therefore often preferred to obtain natural and supple shapes, especially in patients who have undergone radiotherapy even years before.…”

Section: Introductionmentioning

confidence: 99%

Enhancing Breast Reconstruction: An Analysis of 117 Patients Undergoing Delayed Autologous Fat Grafting

Fitoussi,

Razzouk,

Raei

2023

Arch Breast Cancer

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Background: The number of total mastectomy patients requesting breast reconstruction is increasing. However, many patients refuse this surgery because the procedures are too complex, too prone to complications, or even just because of the fear of breast implants and their long-term consequences. In this study, a comprehensive assessment of the results and complications of only fat grafting breast reconstruction is presented. Methods: Between 2012 and 2021, 127 fat grafting breast reconstruction was performed in 117 patients who previously received total mastectomy. These included 70 cases of delayed breast reconstruction (DBR) and 57 "conversions," i.e., removal of a reconstructive implant replaced by iterative fat injections. The patients were fully informed about the procedure's risks and benefits before intervention. All the patients signed an informed consent. The procedure, complications, and results were analyzed on a regular basis every 3-6 months (average follow-up of 3 years). Results: Data from 117 patients with a mean age of 59 years (25-83) were included in this study. The mean body mass index was 23 (19-30). Seventy patients had received radiotherapy before mastectomy (55%). An average of 3.17 injections (2 to 7) with an average volume of 300 cc were required to finalize the breast reconstruction, with a total average injected volume of 933 cc. Simple fat transfers were performed on an outpatient basis except for bilateral or associated procedures. In 48 cases (40%), the patients received appropriate procedures on the contralateral breast to make it symmetrical. Complications happened in 10 percent of cases, mostly minor complications like fatty cysts or much-localized Cytosteatonecrosis though in a limited number of patients, more serious problems with hematomas, abscesses, diffuse Cytosteatonecrosis or very extensive lymphoceles appeared. Conclusion: The findings of this study support fat transfer breast reconstruction as a safe procedure with acceptably low complications, even in patients who have received radiotherapy in their history. Furthermore, this procedure can be applied in an outpatient setting. It seems that the application and the indications of this easy and feasible procedure will be increased in the coming years.

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“…Several studies have reported AFT in combination with breast reconstruction after breast cancer treatment is safe oncologically, particularly in terms of not increasing the risk of locoregional recurrence (LRR) (7)(8)(9). Meanwhile, a case-control study (10) by Berti et al showed an increased risk of local recurrence (LR) after AFT in women who were treated for invasive breast cancer. Chung et al also found a significantly higher risk of cancer recurrence in a population of breast cancer patients who underwent immediate reconstruction (11).…”

Section: Introductionmentioning

confidence: 99%

The prognosis outcomes of autologous fat transfer for breast reconstruction after breast cancer surgery: a systematic review and meta-analysis of cohort studies

Tian¹,

Chu²,

Zhang³

et al. 2022

Gland Surg

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Background: Autologous fat transfer (AFT) is a minimally invasive technique that employs a patient's own fat to correct disfiguring sequelae for breast reconstruction in postoperative breast cancer patients. However, the results of studies on this topic were controversial. In order to explore the effect of AFT on breast reconstruction after breast cancer surgery, we included cohort studies and conducted a meta-analysis.Methods: A literature search was conducted using PubMed, Embase, Cochrane Library, and Web of Science databases for relevant studies published up to September 14, 2020. We identified the eligible studies based on the PICOS principles, populations (patients diagnosed with breast cancer), interventions (patients undergoing AFT after breast cancer surgery), controls (patients who did not receive AFT after breast cancer surgery), outcomes [local recurrence (LR) rate, regional recurrence (RRR) rate, locoregional recurrence (LRR) rate, distant metastasis rate, systemic recurrence (SR) rate, and total death rate], study design (cohort studies). The I 2 statistic was conducted to estimate heterogeneity. Relative risks (RRs) with 95% confidence intervals (CIs) were presented to evaluate whether AFT compromises oncological safety in breast reconstruction. Funnel plots and Egger's test were adopted to assess publication bias. Quality assessment for the included studies using the Newcastle-Ottawa Scale (NOS).Results: Twenty-two cohort studies involving 9,971 postoperative patients with breast cancer were identified, with 3,622 receiving AFT being the experimental group, and 6,349 not receiving AFT in the control group. The overall quality of the included studies was rated as high. No significant differences in the

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Oncological Safety of Autologous Fat Grafting in Breast Reconstruction after Mastectomy for cancer: A case-control study

Cited by 8 publications

References 20 publications

Breast fat grafting and cancer: a systematic review of the science behind enhancements and concerns

Breast fat grafting and cancer: a systematic review of the science behind enhancements and concerns

Enhancing Breast Reconstruction: An Analysis of 117 Patients Undergoing Delayed Autologous Fat Grafting

The prognosis outcomes of autologous fat transfer for breast reconstruction after breast cancer surgery: a systematic review and meta-analysis of cohort studies

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