Although lipofilling of the breast is performed worldwide in thousands of patients per year, including as an alternative to implant placement for breast augmentation in some patients, there has been no study published with a control group regarding the oncologic safety of lipofilling in general or lipofilling of the breast.
The authors of a study conducted on patients between 1981 and 2014 assessed the risk of locoregional and systemic recurrence in patients who underwent lipofilling for breast reconstruction. The Institutional Review Board of The University of Texas M. D. Anderson Cancer Center approved this retrospective analysis.
The patients for analysis were identified in two stages. First, the database of prospectively collected data maintained by the M. D. Anderson Department of Plastic Surgery was searched for all patients who underwent segmental or total mastectomy for breast cancer or breast cancer risk reduction followed by breast reconstruction with lipofilling as an adjunct or primary procedure. For the patients identified as a result of this search, the dates of segmental or total mastectomy ranged from June of 1981 through April of 2013, and the dates of lipofilling ranged from January of 2001 through February of 2014. In the second stage of patient identification, the database of prospectively collected data maintained by the M. D. Anderson Department of Breast Medical Oncology was searched to identify patients with breast cancer who underwent mastectomy and breast reconstruction during the period from June of 1981 through April of 2013 but did not undergo lipofilling (i.e., controls).
To assess the effect of lipofilling on the risk of locoregional recurrence of breast cancer, authors compared outcomes in the breasts reconstructed with (i.e., cases) and without (i.e., controls) lipofilling after mastectomy for breast cancer. Breasts reconstructed with lipofilling after mastectomy for breast cancer risk reduction or benign disease were analyzed to achieve a secondary objective of determining whether patients who underwent lipofilling after risk-reducing mastectomy had an increased risk of primary breast cancer.
The initial search of the plastic surgery database identified 1024 consecutive breasts reconstructed with lipofilling, 719 of them cancerous breasts (cases) and 305 of them cancer-free breasts (removed for breast cancer risk reduction). Of the 305 cancer-free breasts, BRCA status was available for 233 patients, of which 33 patients were carriers of the BRCA1/BRCA2 mutation
The study results showed no increase in locoregional recurrence, systemic recurrence, or second breast cancer. These findings support the oncologic safety of lipofilling in breast reconstruction.
Source: Plast Reconstr Surg. 2016; 137(2):385-393.