Total breast reconstruction using large-volume condensed and viable fat grafting after mastectomy

Zhang, Xinyu; Cai, Lei; Yin, Bo; Han, Xuefeng; Li, Facheng

doi:10.1016/j.bjps.2020.10.109

Cited by 14 publications

(15 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The current available literature examining the long-term safety profile of AFGs in breast cancer reconstruction has largely focused on cohorts from women who underwent mastectomies or (small cohorts of combined mastectomy and BCT patients) with AFG as an adjunct procedure. The largest of these studies have shown AGF to be safe and did not demonstrate any increased rate of cancer recurrence in these cohorts 31–34 . Given that BCTs and mastectomies have similar recurrence rates and overall outcomes (in appropriately selected patients) after adjusting or potential confounders, it can be hypothesized that when used in patients undergoing BCT, adjunct treatment with AFG would have a similar long-term safety profile as well 35–38 .…”

Section: Discussionmentioning

confidence: 99%

“…The largest of these studies have shown AGF to be safe and did not demonstrate any increased rate of cancer recurrence in these cohorts. [31][32][33][34] Given that BCTs and mastectomies have similar recurrence rates and overall outcomes (in appropriately selected patients) after adjusting or potential confounders, it can be hypothesized that when used in patients undergoing BCT, adjunct treatment with AFG would have a similar long-term safety profile as well. [35][36][37][38] However, despite these assumptions, there is no definitive literature to support this point.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Oncologic Safety in Autologous Fat Grafting After Breast Conservation Therapy

et al. 2023

View full text Add to dashboard Cite

Background Autologous fat grafting (AFG) is often used to reconstruct defects after breast conservation therapy (BCT). However, concerns exist about the possibility of AFG-related recurrence or metastasis. This study aims to evaluate the literature to evaluate oncologic outcomes in patients undergoing AFG at the time of BCT. Methods A systematic review of articles related to AFG based reconstruction at the time of BCT from 1970 to 2021 was performed via PubMed. Patients were grouped based on the presence or lack of AFG usage at the time of BCT, and oncologic outcomes and complications were compared. Results Of the 146 articles identified, 15 were included. Nine hundred patients underwent BCT alone and 1063 patients underwent BCT with AFG patients. Similar average follow-up time was observed between the groups, 58.7 months (BCT only) and 55.2 months (BCT with AFG). On pooled analysis, no difference was identified in local recurrence 4.8% (43 patients) of the BCT group and 3% (32 patients) in the AFG group (P = 0.8), metastasis 4.8% (43 patients) of the BCT group and 6.9% (73 patients) in the AFG group (P = 0.3), or fat necrosis (P = 0.44). Meta-analysis additionally did not identify any statistically significant odds ratios between the BCT only group and BCT with AFG group when evaluated for total recurrence, local recurrence, metastasis or fat necrosis. Conclusions The results show no significant difference in cancer recurrence or metastasis in the BCT only group versus BCT and AFG, showing that fat grafting has safe outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Oncologic Safety in Autologous Fat Grafting After Breast Conservation Therapy

et al. 2023

View full text Add to dashboard Cite

show abstract

“…In the present meta-analysis, there was no significant difference in distant metastasis between the AFT group and non-AFT group. Similarly, another study showed no remote metastasis was documented during the followup period (40). Only 6 studies included total deaths, and no prominent findings were found concerning the rate of distant metastasis because there was no significant difference between the 2 groups.…”

Section: Discussionmentioning

confidence: 96%

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

View full text Add to dashboard Cite

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

show abstract

“…Alharbi et al demonstrated significantly higher viability and migration of ADSCs collected by microfat techniques 23 . Harvesting fat with a cannula with 0.3‐ and 0.5‐mm‐diameter side holes is time‐consuming, and the adipocytes are severely damaged as demonstrated by the proportion of oil in the top layer 24 . A recent innovation consists in the intraoperative mechanical fragmentation of adipose tissue, a process that does not significantly affect stromal cells viability but impacts on adipocytes integrity 20,25,26 .…”

Section: Introductionmentioning

confidence: 99%

“…23 Harvesting fat with a cannula with 0.3-and 0.5-mm-diameter side holes is time-consuming, and the adipocytes are severely damaged as demonstrated by the proportion of oil in the top layer. 24 A recent innovation consists in the intraoperative mechanical fragmentation of adipose tissue, a process that does not significantly affect stromal cells viability but impacts on adipocytes integrity. 20,25,26 Mechanical fragmentation preserves microclusters with a number of perivascular elements higher than SVF and similar to whole adipose tissue.…”

mentioning

confidence: 99%

Therapeutic potential of adipose tissue‐derivatives in modern dermatology

Bellei

Migliano

Picardo

2022

Experimental Dermatology

View full text Add to dashboard Cite

Stem cell‐mediated therapies in combination with biomaterial and growth factor‐based approaches in regenerative medicine are rapidly evolving with increasing application beyond the dermatologic field. Adipose‐derived stem cells (ADSCs) are the more frequently used adult stem cells due to their abundance and easy access. In the case of volumetric defects, adipose tissue can take the shape of defects, restoring the volume and enhancing the regeneration of receiving tissue. When regenerative purposes prevail on volume restoration, the stromal vascular fraction (SVF) rich in staminal cells, purified mesenchymal stem cells (MSCs) or their cell‐free derivatives grafting are favoured. The therapeutic efficacy of acellular approaches is explained by the fact that a significant part of the natural propensity of stem cells to repair damaged tissue is ascribable to their secretory activity that combines mitogenic factors, cytokines, chemokines and extracellular matrix components. Therefore, the secretome's ability to modulate multiple targets simultaneously demonstrated preclinical and clinical efficacy in reversing pathological mechanisms of complex conditions such atopic dermatitis (AD), vitiligo, psoriasis, acne and Lichen sclerosus (LS), non‐resolving wounds and alopecia. This review analysing both in vivo and in vitro models gives an overview of the clinical relevance of adipose tissue‐derivatives such as autologous fat graft, stromal vascular fraction, purified stem cells and secretome for skin disorders application. Finally, we highlighted the major disease‐specific limitations and the future perspective in this field.

show abstract

Total breast reconstruction using large-volume condensed and viable fat grafting after mastectomy

Cited by 14 publications

References 36 publications

Oncologic Safety in Autologous Fat Grafting After Breast Conservation Therapy

Oncologic Safety in Autologous Fat Grafting After Breast Conservation Therapy

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

Therapeutic potential of adipose tissue‐derivatives in modern dermatology

Contact Info

Product

Resources

About