Abstract P5-16-14: Outcome of lipofilling in patients with a history of breast cancer: A retrospective cohort study
Authors: Thiessen F , De Schrijver L , De Decker M , Tondu T , Van Goethem M , Tjalma WA 
Published: May 2019

Background:Autologous fat grafting [AFG] is a surgical technique used to correct breast deformities or to reconstruct partial breast deformities after breast conservative treatment [BCT] or mastectomy for breast cancer. However, a strong debate remains upon the topic of safety and the oncological risk after lipofilling. There is a need for more studies assigned with a higher level of evidence.

Objective:This retrospective cohort study aimed to provide a strong evidence-based argument concerning the safety of fat grafting in patients who underwent breast cancer surgery in comparison to a group with similar characteristics who did not receive lipofilling.

Methods: Two cohorts consisting of women with a history of breast cancer were retrospectively assembled. All patients underwent BCT and/or a mastectomy as breast cancer treatment. An intervention population of patients that had received primary or secondary lipofilling was statistically compared to a control population of patients that had received a breast reconstruction without lipofilling.

Results: Fifty patients with a mean age of 53.6 ± 9.3 years at the time of lipofilling were included in the intervention cohort. The control group included 67 patients with a mean age of 52.8 ± 8.5 years at the time of breast reconstruction. Both cohorts showed no significant differences for demographic or oncological data. Mean follow-up time was 15.0 ± 15.6 months in the intervention group and 45.4 ± 35.1 months in the control group. The prevalence of the complications are shown in the table. No complications were seen in 35 patients [70%] after lipofilling. Fat necrosis was mostly observed [n=15] but no infections or local oncological recurrences were reported. In the control group a complication-free follow-up occurred in 38 patients [56.7%] after breast reconstruction. One control patient demonstrated a local oncological recurrence. A higher prevalence of infections was observed in the control population [p = 0.048] and the prevalence of fat necrosis was higher after lipofilling [p = 0.028].

Prevalence of complications Study populationStudy populationControl populationControl populationp-valueLocal oncological recurrence0 1(1.5%)0.386Infection0 5(7.5%)0.048Fet necrosis15(30.0%)9(13.4%)0.028Microcalcifications3(6.0%)3(4.5%)0.712Other1(2.0%)17(25.4%)0.086- hematoma1(2.0%)5(7.5%) - seroma0 2(3.0%) - capsular contracture0 1(1.5%) -implant leak0 1(1.5%) - implant/flap loss0 6(9.0%) - implant redo0 1(1.5%) - rash0 1(1.5%) None35(70%)38(56.7%)0.142

Conclusion: Lipofilling is a safe technique for breast reconstruction in patients with a history of breast cancer. There is no increase in local oncological recurrence. A side effect is an increase in fat necrosis which can potentially lead to more investigations.

Citation Format: Thiessen F, De Schrijver L, De Decker M, Tondu T, Van Goethem M, Tjalma WA. Outcome of lipofilling in patients with a history of breast cancer: A retrospective cohort study [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-16-14.