Fat Injection for Postmastectomy Breast Reconstruction Does Not Increase Risk of Recurrent Breast Cancer
The use of lipofilling for postmastectomy breast reconstruction does not increase the risk of recurrent breast cancer. These findings, from an analysis of a plastic surgery database, were published in Plastic and Reconstructive Surgery.1 Lipofilling is a technique that uses the patient's own fat cells to optimize results of breast reconstruction.
"Our controlled study shows that, used as part of breast reconstruction, lipofilling is a safe procedure that does not increase the risk of recurrent or new breast cancers," commented Steven J. Kronowitz, MD, of Kronowitz Plastic Surgery, Houston (formerly of M.D. Anderson Cancer Center), a member surgeon of the American Society of Plastic Surgeons and lead author of the study. Lipofilling uses fat obtained by liposuction from 1 part of the body, such as the abdomen or thighs, to enhance the appearance of the breast.
The researchers analyzed a series of more than 1000 partial or total mastectomies that were followed by breast reconstruction in a plastic surgery database covering 1981 to 2014. The database included 719 breasts treated with lipofilling and 670 breasts reconstructed without lipofilling. Nearly one-third (30%) of the cases involved risk-reducing mastectomy in women at high genetic risk for breast cancer.
Both groups of women had similar rates of recurrent or new breast cancers. The rate of locoregional recurrence (in the breast and surrounding area) was not significantly different between groups: 1.3% for women who underwent lipofilling vs 2.4% in those who did not.
In addition, both women who underwent lipofilling and those who did not had similar rates of systemic (distant) cancer recurrence: 2.4% with lipofilling vs 3.6% without.
Among subgroups, only women receiving hormone therapy had a difference, as lipofilling was associated with a small but significant increase in locoregional recurrence risk: 1.4% vs 0.5%.
Though lipofilling is increasingly used to optimize the cosmetic results of breast reconstruction, some plastic surgeons have still been reluctant to use lipofilling out of concern that it might affect the risk of primary or recurrent breast cancer. This is the first study to compare a control group without lipofilling to women who underwent lipofilling.
This study found no evidence that lipofilling affects the risk of initial breast cancer for high-risk women who undergo preventive mastectomy.
"Our results provide new evidence that lipofilling, used as part of breast reconstruction, is a safe procedure that does not increase the risk of recurrent or new breast cancer after mastectomy," Kronowitz commented. While highlighting the need for further research, the researchers hope their findings will encourage more plastic surgeons to use lipofilling to provide the best possible results of breast reconstruction for their patients undergoing breast cancer surgery.
1. Kronowitz SJ, Mandujano CC, Liu J, et al. Lipofilling of the breast does not increase the risk of recurrence of breast cancer: a matched controlled study. Plast Reconstr Surg. 2016;137(2):385-393. doi:10.1097/01.prs.0000475741.32563.50.