by Hanson, Summer E.; Kapur, Sahil K.; Garvey, Patrick B.;
Hernandez, Mike; Clemens, Mark W.; Hwang, Rosa F.; Dryden, Mark J.; Butler,
Charles E.
Plastic and
Reconstructive Surgery: August 2020 -
Volume 146 - Issue 2 - p 215-225
Background:
Autologous fat grafting is a useful adjunct following breast
reconstruction. The impact of autologous fat grafting on oncologic safety and
surveillance remains questionable, particularly following breast conservation
therapy.
Methods:
The authors performed a retrospective review of patients who
underwent delayed fat grafting following breast conservation therapy between
2006 and 2016. A control group of conservatively managed patients without
grafting was matched for cancer stage, age, body mass index, and follow-up.
Outcomes included locoregional recurrence and oncologic surveillance.
Results:
Seventy-two patients were identified per cohort. There were
no differences in median age (50 years versus 51 years; p = 0.87), body mass
index (28.2 kg/m2 versus 27.2 kg/m2; p = 0.38), or length of follow-up (61.9
months versus 66.8 months; p = 0.144) between controls and grafted patients,
respectively. Overall, four patients in each cohort experienced recurrence (5.6
percent; p = 1.00) with similar cumulative incidence estimates observed
(log-rank test, p = 0.534). There were no significant differences in palpable
mass (9.7 percent versus 19.4 percent; p = 0.1), fat necrosis (34.7 percent
versus 33.3 percent; p = 0.86), calcifications (37.5 percent versus 34.7
percent; p = 0.73), or indication for breast biopsy (15.3 percent versus 22.2
percent; p = 0.23) between breast conservation and breast conservation therapy
plus autologous fat grafting cohorts, respectively.
Conclusions:
Overall, the authors found no difference in recurrence rates
after breast conservation with or without delayed fat grafting. Furthermore,
there were no differences in the rates of fat necrosis, palpable mass, and
abnormal radiographic findings. This study represents the longest follow-up to
date in in a large matched study of autologous fat grafting with breast
conservation therapy demonstrating oncologic safety and no interference with
follow-up surveillance. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
