Lipofilling or lipotransfer is a relatively new method to do secondary correction of smaller partial mastectomy defects after breast-conserving therapy of breast cancer. Do patients have an increased risk for local recurrences after lipofilling or is it a safe procedure in breast cancer patients ?
Lipofilling can cause cysts, fat necrosis or calcifications in breast tissue , during palpation you can feel mass, during usg you can see cysts or because of calcifications you think this can be a local recurrence,also i think you have to avoid partial mastectomy because of high risk of local recurrence. I think best way is if possible a nipple sparing mastectomy and reconstruction with breast implant + Alloderm ( acellular dermal matrix).
Breast conserving therapy for breast cancer patients is reserved for limited cancer size and local disease.
The only study available on the specific risk of lipofilling after breast conserving therapy is the Italian study by Petit JY et al., Evaluation of fat grafting safety in patients with intraepithelial neoplasia: a matched-cohort study. Ann Oncol. 2013 Jun;24(6):1479-84. The authors could show an increased risk of local recurrence after lipofilling in the "in situ breast cancer" subgroup after lipofilling.
The general risk of lipofilling after 3 decades of fatgrafting on the breast level is unknown, though conventional lipofillig is considered safe due to a large body of clinical experience. However stem-cell enhanced techniques bear an unknown risk. Also the risk of inducing breast cancer in the BRCA positive patients is unknown. Our group has reviewed the basic scientific literature and clinical reports recently (Krumboeck et al., Fat grafting and stem cell enhanced fat grafting to the breast under oncological aspects--recommendations for patient selection. Breast. 2013 Oct;22(5):579-84.) to give some recommendations for patient safety.
The risk of recurrence is closely related to the type of conservative surgery (i.e. lumpectomy) and not to lipofilling.
We don´t know yet. We know that lipofilling and the herein contained preadipocytes (MST) in vitro can promote tumor growth.
Therefor, in a lot of countries (like France and Germany) Lipofilling after breast conserving therapy, which in itself implies that there may be tumorous tissue left behind, lipofilling, for now, should not be performed.
future will tell.
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