Fat Grafting and Breast Cancer
Autologous fat grafting (using the patient’s own fat) is one technique that plastic surgeons use to help contour a reconstructed breast after mastectomy or to fill in defects after a patient has had a lumpectomy alone. I must admit that I have been concerned about injecting fat into the breast as there exist theoretical concerns that various hormones and other molecules secreted by the fat may in fact stimulate the appearance and/or growth of breast cancer cells. Recent reports have attested to the safety of fat grafts in the breast cancer patient. Further evidence as to the safety of this procedure was published this month in the journal Plastic and Reconstructive Surgery. The authors study group included 322 breast cancer patients who underwent fat grafting. The investigators matched the treated patients with an identical number of matched breast cancer patients who did not receive a fat grafting procedure.
There was no difference in recurrence rate, incidence of metastatic disease or mortality between the treated and the control group. The good part about the design of this study was the authors identified a matched control group of an equal number of patients who did not receive any fat grafting. Two criticisms that could be leveled against this study are that it was a retrospective study and the longest follow-up was 10 years with an average of about 4.5 years. The ideal studies are prospective, not retrospective. In addition, breast cancer is a long-term disease as evidence by the recent announcement of a breast cancer recurrence in Olivia Newton John after a 25 year disease free interval. A longer average follow-up, therefore, would have been more comforting.
In summary, despite early concerns about the risk of activation of breast cancer cells in woman undergoing autologous fat grating after lumpectomies or mastectomies, the trend in the studies, data and experience seems to be pointing to the safety of this procedure.