Lipofilling found safe after breast cancer surgery

Preliminary experience suggests that lipofilling—using fat from elsewhere in the patient's body for contouring of the breasts—is a safe procedure for women who have undergone breast cancer surgery, reports a study in the August issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

"Lipofilling [after] breast cancer treatment leads to a low complication rate and does not affect the radiologic follow-up after breast-conserving surgery," according to Dr. Jean Yves Petit of the European Institute of Oncology, Milano, and colleagues. However, the researchers emphasize that long-term follow-up studies are needed to confirm the safety of the lipofilling procedure.

Experience at Three Hospitals Shows Low Complication Rate
Researchers at three French and Italian hospitals evaluated 513 women who underwent lipofilling after breast cancer surgery from 2000 to 2010. In the lipofilling procedure, fat obtained by liposuction from one part of the body—for example, the thighs—is injected into the breast. Lipofilling for breast contouring was performed after mastectomy and breast reconstruction in 370 women and after breast-conserving surgery (lumpectomy) in 143 women.

Lipofilling was performed an average of about three years after breast cancer surgery. The average amount of fat transferred was 107 cc, or about four fluid ounces. Some women had more than one lipofilling procedure because of reabsorption of the injected fat.

The overall complication rate was low: less than three percent. Most complications were related to necrosis (cell death) of some of the injected fat. However, there were few serious complications.

During follow-up, breast cancer recurrences developed in 5.6 percent of patients. Follow-up mammograms from women who underwent breast-conserving surgery and lipofilling showed new abnormalities in 12 cases, two of which were recurrent breast cancers. There was no evidence that lipofilling interfered with the ability to detect recurrence. However, Dr. Petit and colleagues emphasize that a biopsy of the area should be obtained if there is any doubt.

Lipofilling is a promising option for breast contouring after breast reconstruction or lumpectomy in women with breast cancer. However, the procedure remains controversial. Although the new study can't prove that lipofilling after breast cancer surgery is safe, it provides reassurance that the complication rate is low. It also suggests that lipofilling doesn't interfere with follow-up mammograms after breast-conserving surgery.

The researchers emphasize the need for further studies of lipofilling after breast cancer surgery, including a larger group of patients, a matched control group, and long-term follow-up. "Until then," Dr. Petit and coauthors conclude, "lipofilling should be performed in experienced hands and a cautious oncologic follow up protocol is advised."

Source Plastic and Reconstructive Surgery