The September 2020 Plastic and Reconstructive Surgery Journal had an article on “Oncologic Safety and Surveillance of Autologous Fat Grafting following Breast Conservation Therapy.” As always, the titles of medical journal articles are a mouthful. In English, they are asking, if you have a lumpectomy or biopsy and get fat grafting to the breasts to make things look better, will the grafted fat 1. increase your risk of breast cancer? or 2. make it hard to find a breast cancer because the fat grafting caused fat necrosis, lumps, bumps, oil cysts, calcifications, etc?
The study was a retrospective review looking over the course of 10 years. Their control was a group that had no fat grafting, matched for cancer stage, age, BMI and follow up.
Findings:
- 72 patients in each cohort
- Median age 50 years
- BMI 28
- Follow up 5 years
- Four patients in each cohort had recurrence.
- No significant difference in palpable mass, fat necrosis, calcifications, or indication for breast biopsy
The study is good in that it was a five year follow up (some issues may take time to present), though retrospective reviews are always a little tricky. It reinforces findings from other studies looking at breast reconstruction treated with lipofilling (fat grafting), which showed no increase in recurrence of cancer locally or systemically.
It is important to know if fat grafting affects your risk for a new breast cancer or makes it hard to detect a cancer. I love fat grafting. It is an important tool in our toolbox for reconstruction, particularly for asymmetry, contour issues, and loss of volume in a particular area like the upper pole / cleavage area. There have been studies in the past linking adipose derived progenitor cells within a tissue graft to cause increased risk for recurrence when looked at in the lab. Those are studies done in vitro. But what happens in real life? At this point multiple studies done on real patients have shown no increased risk of recurrence or systemic disease.