Fat Grafting following Internal Tissue Expansion: An Option for Breast Reconstruction after Total Mastectomy

Kolasiński, Jerzy; Pyka, Pawel

doi:10.1097/gox.0000000000004088

Cited by 4 publications

(2 citation statements)

References 33 publications

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“…However, these same cells harbor a theoretical risk in their potential to impact the recurrence of a breast cancer, given they are multipotent stem cells. Consequently, there has been significant controversy over the long-term safety profile of AFG in women undergoing reconstruction for breast cancer 29,30 . Although there has been some prior work done evaluating the use of AFG after mastectomy, to date, there remains a lack of consensus regarding this topic in the setting of breast-conserving therapies, such as lumpectomies.…”

Section: Discussionmentioning

confidence: 99%

Oncologic Safety in Autologous Fat Grafting After Breast Conservation Therapy

et al. 2023

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Background Autologous fat grafting (AFG) is often used to reconstruct defects after breast conservation therapy (BCT). However, concerns exist about the possibility of AFG-related recurrence or metastasis. This study aims to evaluate the literature to evaluate oncologic outcomes in patients undergoing AFG at the time of BCT. Methods A systematic review of articles related to AFG based reconstruction at the time of BCT from 1970 to 2021 was performed via PubMed. Patients were grouped based on the presence or lack of AFG usage at the time of BCT, and oncologic outcomes and complications were compared. Results Of the 146 articles identified, 15 were included. Nine hundred patients underwent BCT alone and 1063 patients underwent BCT with AFG patients. Similar average follow-up time was observed between the groups, 58.7 months (BCT only) and 55.2 months (BCT with AFG). On pooled analysis, no difference was identified in local recurrence 4.8% (43 patients) of the BCT group and 3% (32 patients) in the AFG group (P = 0.8), metastasis 4.8% (43 patients) of the BCT group and 6.9% (73 patients) in the AFG group (P = 0.3), or fat necrosis (P = 0.44). Meta-analysis additionally did not identify any statistically significant odds ratios between the BCT only group and BCT with AFG group when evaluated for total recurrence, local recurrence, metastasis or fat necrosis. Conclusions The results show no significant difference in cancer recurrence or metastasis in the BCT only group versus BCT and AFG, showing that fat grafting has safe outcomes.

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Section: Discussionmentioning

confidence: 99%

Oncologic Safety in Autologous Fat Grafting After Breast Conservation Therapy

et al. 2023

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“…In a meta-analysis of 21 studies, the estimated number of transplants required to complete whole breast reconstruction was inconsistent, ranging from 2 to 7 sessions 11 , 15 . In a recent report of 22 cases of total breast reconstruction with fat grafting, 11 cases (50%) abandoned the use of fat only reconstruction and converted to breast implants due to inadequate engraftment 45 . This indicates that engraftment of fat grafts has conventionally been unreliable in whole breast reconstruction until now.…”

Section: Discussionmentioning

confidence: 99%

Successful fat-only whole breast reconstruction using cultured mature adipocytes and conditioned medium containing MCP-1

Yanaga,

Koga,

Nishina

et al. 2023

Sci Rep

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A mastectomy is a curative treatment for breast cancer. It causes breast and soft tissue deficits, resulting in a chest with poor vascularity. Autologous tissue breast reconstruction is commonly associated with donor site morbidity. Breast implants are another reconstruction alternative, but they are associated with infection, rupture, and the need for replacement. Autologous aspirated fat grafting has appeared as an ideal breast reconstruction method, but low graft viability and high resorption remain as the main shortcomings. We developed a novel method for fat-only grafts using cultured mature adipocytes (CMAs) mixed with their condition medium. Twenty-five mastectomy patients, aged 32–72 years, received a mixed grafting of CMAs, MCP1-containing condition medium, and fat grafts for total breast reconstruction. In follow-up periods of 24–75 months, MRI analysis showed full thickness fat-engraftment. The cell proliferation marker Ki67 was negative in post-transplant biopsy specimens from all patients. Aesthetic full breast morphology was achieved, patient satisfaction was evaluated 1 year and 3–6 years after surgery. All grafts were confirmed safe, demonstrating high reliability and long-term sustainability.

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