Autologous Fat Grafting Reduces Pain in Irradiated Breast: A Review of Our Experience

Abstract

Introduction. Pain syndromes affect women after conservative and radical breast oncological procedures. Radiation therapy influences their development. We report autologous fat grafting therapeutical role in treating chronic pain in irradiated patients. Materials and Methods. From February 2006 to November 2014, we collect a total of 209 patients who meet the definition of “Postmastectomy Pain Syndrome” (PMPS) and had undergone mastectomy with axillary dissection (113 patients) or quadrantectomy (96 patients). Both procedures were followed by radiotherapy. We performed fat grafting following Coleman's procedure. Mean amount of adipose tissue injected was 52 cc (±8.9 cc) per breast. Seventy-eight in 209 patients were not treated surgically and were considered as control group. Data were gathered through preoperative and postoperative VAS questionnaires; analgesic drug intake was recorded. Results. The follow-up was at 12 months (range 11.7–13.5 months). In 120 treated patients we detected pain decrease (mean ± SD point reduction, 3.19 ± 2.86). Forty-eight in 59 patients stopped their analgesic drug therapy. Controls reported a mean ± SD decrease of pain of 1.14 ± 2.72. Results showed that pain decreased significantly in patients treated (p < 0.005, Wilcoxon rank-sum test). Conclusion. Our 8-year experience confirms fat grafting effectiveness in decreasing neuropathic pain.

Autologous fat grafting efficacy in treating PostMastectomy pain syndrome: A prospective multicenter trial of two Senonetwork Italia breast centers

“…Needling effect is well known and leads to regeneration itself increasing the production of citokyne and local mediators. 13 The combined effect of fat grafting and use of needles is the responsible of the effect of fat grafting in pain syndromes and both aspects are needed for a full response.…”

“…9 Our group extensively adopted such a procedure to treat scar tissue-related pathologies, degenerative diseases, and volume deformities. [9][10][11][12][13][14][15][16][17] In 2006, we were the first to treat patients undergoing mastectomy and axillary dissection followed by radiotherapy, 10 demonstrating the ability of the lipostructure to alleviate PMPS symptoms.…”

The post-mastectomy pain syndrome-A systematic review of the treatment modalities

“…Considering the authors' interest for our study, we would like to add our more recent reports where we retrospectively evaluate our 10 years experience on the use of autologous fat grafting in the treatment of PMPS focusing on irradiated breast. 4 We recently confirmed the pain reduction effect of this technique reviewing a total of 120 treated patients, affected by PMPS following mastectomy or quadrantectomy and radiotherapy. In this larger group, we detected a statistically significant reduction in the visual analog scale scores when comparing the assessment performed before and after the treatment.…”

Autologous Fat Transfer as a Treatment for Peripheral Neuropathic Pain without Apparent Cause

“…In patients with postmastectomy pain syndrome, several studies revealed that AFT significantly decreased the VAS score versus nonoperated controls, with a mean decrease of >3 points. 11 , 12 , 18 …”