Autologous fat transfer (AFT) enhances the cosmetic results of breast reconstruction and corrects breast conserving operation sequelae. The question of its oncological safety remains, as in-vitro experiences have shown that adipocytes can stimulate cancer cell proliferation. This study analysed the records of patients who had AFT after breast cancer from 2004-2009. The primary end-point was cancer recurrence. The secondary end-points were AFT complications and post-AFT mammogram modifications. Sixty-four patients (100 AFT) were included. The mean follow-up for AFT was 46.44 months (SD = 21.4). Two breast cancer recurrences were recorded (3.1%). Among 55 mammograms analysed, only one patient presented radiological abnormalities. One complication of AFT (donor-site infection) was recorded. This series is in favour of the oncological safety of AFT after breast cancer. An accurate evaluation of the recurrence risk, before performing AFT, is an essential prerequisite and must lead one to postpone or avoid this procedure in high-risk patients.
PURPOSE: To evaluate the clinical outcomes of a very-accelerated partial breast irradiation (vAP-BI) in the elderly based on a single fraction of multicatheter interstitial high-dose rate brachytherapy (MIB). Mature results with a median follow-up of 5 years. METHODS AND MATERIALS: From November 2012 to September 2014, 26 patients (pts) ($70) with early breast cancer were enrolled in a prospective phase II trial (NCT01727011). After lumpectomy, intraoperative catheter implant was performed for postoperative APBI (single fraction 16 Gy). Surveillance was performed twice a year after APBI. Oncologic outcome (local [LRFS], metastasis-free survival, cancer-specific survival, and overall survival [OS]) as well as late toxicity and cosmetic outcome were investigated. RESULTS: Median age was 77 years [69e89]. After a median follow-up of 63 months [60e68], 5-year LRFS, metastasis-free survival, cancer-specific survival, and overall survival rates were 100%, 95.5%, 100%, and 88.5%, respectively. Late toxicity was observed in 5 pts (19.2%) with a total of five events: 3 pts G1 (60%); and 2 pts G2 (40%). The observed late side effects were breast pain in 1 pt (G2 cytosteatonecrosis with occasional acetaminophen consumption), hypopigmentation (puncture site) in 2 pts (G1) and breast fibrosis in 2 pts (G1: 1 pt; G2: 1 pt). Cosmetic evaluation was excellent for 21 pts (81%) and good for 2 pts (19%). CONCLUSION: For elderly with early breast cancer, a vAPBI using a single fraction of postoperative MIB (16 Gy) provides excellent oncologic results, mainly in terms of local control and cancer death. Late toxicity and cosmetic profile are acceptable.
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