Evaluation of Oncological Safety of Fat Grafting After Breast-Conserving Therapy: A Prospective Study

Měšťák, Ondřej; Hromadkova, Veronika; Fajfrova, Monika; Molitor, Martin; Měšťák, J

doi:10.1245/s10434-015-4908-2

Cited by 44 publications

(35 citation statements)

References 45 publications

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“…Additional meta-analysis of the remaining unmatched cohorts 26,40,42,44,47,49,61,68,71 was possible only for the IRD of LRR for period C, as control subjects did not have a disease-free interval (period A) equivalent to that in the AFT group. The overall IRD was -0⋅27 (-0⋅43 to -0⋅11) per cent per year, with a significantly lower overall LRR rate among patients who had AFT (P = 0⋅004).…”

Section: Results Of Meta-analysismentioning

confidence: 99%

“…Finally, data from all non-overlapping populations in case series 17 -19,21,24,27,28,30,33,35,36,38,43,46,50,52-54,56,63,64,67,72,74 as well as AFT treatment arms of cohort studies (References 26,31,32,[39][40][41][42]45,47,49,61,68,70,71 and T. Krastev et al,unpublished results) were pooled to provide an estimate of the combined incidence rate of LRR after exposure to AFT (period B). The raw incidence rate for all patients was 0⋅73 (0⋅56 to 0⋅94) per cent per year ( Fig.…”

Section: Results Of Meta-analysismentioning

confidence: 99%

“…Gale et al 32 Krastev Fertsch et al 31 Gale et al 32 26 Kim et al 40 Kronowitz et al 42 Laporta et al 44 Masia et al 47 Mestak et al 50 Pinell-White et al 61 Seth et al 68 Stumpf et al 71 Mestak et al 49 Stumpf et al 71 RE model (I 2 = 41·00%)…”

Section: Re Modelmentioning

confidence: 99%

“…To place the measured pooled effect estimate in context for the general breast cancer population, it was compared with the reported incidence rates in large historical cohorts. Zhu et al 74 Tissiani and Alonso 72 Stumpf et al 71 Silva-Vergara et al 70 Semprini et al 67 Seth et al 68 Rigotti et al 64 Riggio et al 63 Pinell-White et al 61 Petit et al 56 Noor et al 54 Moltó Garciá et al 53 Missana and Germain 52 Mirzabeigi et al 50 Mestak et al 49 Masia et al 47 Manconi et al 46 Longo et al 45…”

Section: Re Modelmentioning

confidence: 99%

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Meta-analysis of the oncological safety of autologous fat transfer after breast cancer

Krastev

Schop

Hommes

et al. 2018

British Journal of Surgery

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Section: Results Of Meta-analysismentioning

confidence: 99%

Section: Results Of Meta-analysismentioning

confidence: 99%

Section: Re Modelmentioning

confidence: 99%

Section: Re Modelmentioning

confidence: 99%

See 2 more Smart Citations

Meta-analysis of the oncological safety of autologous fat transfer after breast cancer

Krastev

Schop

Hommes

et al. 2018

British Journal of Surgery

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“…Indeed, using a model of autologous fat grafting, Massa et al reported increased proliferation of several breast cancer lines co-cultured with either induced adipocytes (i.e., differentiated from fibroblasts) or intact adipose tissue samples obtained from liposuction patients (245). However, a recently published prospective matched case-control analysis found no significant differences in locoregional recurrence in patients who received autologous fat grafting versus those who did not (249). Although cases and controls were matched for hormone receptor status in this study, no analysis was conducted to evaluate potential differences in recurrence by molecular tumor subtype, potentially due to the limited sample size and low locoregional event rate.…”

Section: Microenvironmental Links Between Adipose Tissue and Cancermentioning

confidence: 99%

Contribution of Adipose Tissue to Development of Cancer

Cozzo

Fuller

Makowski

2017

Comprehensive Physiology

168

130

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Solid tumor growth and metastasis require the interaction of tumor cells with the surrounding tissue, leading to a view of tumors as tissue-level phenomena rather than exclusively cell-intrinsic anomalies. Due to the ubiquitous nature of adipose tissue, many types of solid tumors grow in proximate or direct contact with adipocytes and adipose-associated stromal and vascular components, such as fibroblasts and other connective tissue cells, stem and progenitor cells, endothelial cells, innate and adaptive immune cells, and extracellular signaling and matrix components. Excess adiposity in obesity both increases risk of cancer development and negatively influences prognosis in several cancer types, in part due to interaction with adipose tissue cell populations. Herein, we review the cellular and noncellular constituents of the adipose “organ,” and discuss the mechanisms by which these varied microenvironmental components contribute to tumor development, with special emphasis on obesity. Due to the prevalence of breast and prostate cancers in the United States, their close anatomical proximity to adipose tissue depots, and their complex epidemiologic associations with obesity, we particularly highlight research addressing the contribution of adipose tissue to the initiation and progression of these cancer types. Obesity dramatically modifies the adipose tissue microenvironment in numerous ways, including induction of fibrosis and angiogenesis, increased stem cell abundance, and expansion of proinflammatory immune cells. As many of these changes also resemble shifts observed within the tumor microenvironment, proximity to adipose tissue may present a hospitable environment to developing tumors, providing a critical link between adiposity and tumorigenesis.

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Long-term Follow-up of Autologous Fat Transfer vs Conventional Breast Reconstruction and Association With Cancer Relapse in Patients With Breast Cancer

et al. 2019

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IMPORTANCE Autologous fat transfer (AFT or fat grafting) has become an invaluable tool for the correction of disfiguring deformities after breast cancer surgery. However, clinical and animal studies have shown conflicting results regarding its oncologic safety. OBJECTIVE To determine whether exposure to AFT vs conventional breast reconstruction is associated with increased rates of cancer relapse in patients with breast cancer. DESIGN, SETTING, AND PARTICIPANTS This matched cohort study involved retrospective medical record review to identify all patients in a local patient database receiving AFT between 2006 and 2014. Each AFT case was matched with a nonexposed control patient with similar baseline characteristics. The mean (SD) follow-up of patients receiving AFT was 9.3 (4.9) years including 5.0 (1.7) years following AFT. Control patients were followed up for a mean (SD) of 8.6 (1.8) years from the primary surgery. Patients were identified through the local patient database of the Tergooi Hospital in Hilversum, the Netherlands. A total of 287 patients with breast cancer (300 affected breasts) who received AFT for breast reconstruction after cancer were included in the intervention group. Each AFT case was matched with a respective control patient based on age, type of oncologic surgery, tumor invasiveness, and disease stage. In addition, individual AFT-control pairs were selected to have the same locoregional recurrence-free interval at baseline. Data were analyzed between 2016 and 2017. EXPOSURES Reconstruction with AFT vs conventional breast reconstruction or none. MAIN OUTCOMES AND MEASURES Primary end points were the cumulative incidences of oncologic events in AFT and control patients and their respective hazard ratios. RESULTS Of the 587 total patients, all were women and the mean age was 48.1 years for the patients undergoing AFT and 49.4 years for the control patients. Eight locoregional recurrences were observed in the treatment group (287 patients) and 11 among the control group (300 patients), leading to an unadjusted hazard ratio of 0.63 (95% CI, 0.25-1.60; P = .33). No increased locoregional recurrence rates were seen in relevant subgroups based on the type of oncological surgery, tumor invasiveness, or pathological stage. In addition, no increased risks with AFT were detected with respect to distant recurrences or breast cancer-specific mortality. CONCLUSIONS AND RELEVANCE No significant differences in the locoregional recurrence rates between the AFT and control groups were observed after 5 years of follow-up. These findings confirm the results of previous studies; therefore, clinical evidence suggesting that AFT is associated with increased risk for cancer relapse is still lacking.

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Evaluation of Oncological Safety of Fat Grafting After Breast-Conserving Therapy: A Prospective Study

Abstract: The recurrence rate in patients reconstructed with fat grafts after BCT was not significantly different from the recurrence rate of control BCT patients.

Cited by 44 publications

References 45 publications

Meta-analysis of the oncological safety of autologous fat transfer after breast cancer

Meta-analysis of the oncological safety of autologous fat transfer after breast cancer

Contribution of Adipose Tissue to Development of Cancer

Long-term Follow-up of Autologous Fat Transfer vs Conventional Breast Reconstruction and Association With Cancer Relapse in Patients With Breast Cancer

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