J Peter Rubin1, Devin Coon, Margarita Zuley, Jonathan Toy, Yuko Asano, Masakazu Kurita, Noriyuki Aoi, Kiyonori Harii, Kotaro Yoshimura. 1. Pittsburgh, Pa.; Edmonton, Alberta, Canada; and Yokohama and Tokyo, Japan From the Division of Plastic Surgery, Department of Surgery, and Department of Radiology, University of Pittsburgh; Division of Plastic Surgery, Department of Surgery, University of Alberta, Edmonton; Cellport Clinic Yokohama; Department of Plastic Surgery, Teikyo University School of Medicine; Department of Plastic Surgery, Kyorin University School of Medicine; and Department of Plastic Surgery, University of Tokyo School of Medicine.
Abstract
BACKGROUND: : One issue in the adoption of autologous fat transfer to the breast is concern over mammographic changes that may obscure cancer detection. The authors compared mammographic changes following fat grafting to the breast with changes seen after breast reduction. METHODS: : Twenty-seven women who had normal preoperative mammograms were treated with fat grafting to the breast, including admixing of autologous adipose stem cells with the fat graft, for cosmetic augmentation. Repeated mammograms were performed 12 months after surgery. As a control group, postsurgical mammograms from 23 reduction mammaplasty patients were compared. Eight academic breast imaging radiologists reviewed each mammogram in a blinded fashion. Outcomes analysis accounting for individual radiologist's tendencies was performed using generalized estimating equations. RESULTS: : The average volume of fat injected per patient was 526.5 cc. Fifty mammograms (27 lipotransfer, 23 breast reduction) were assessed. Differences in interpretation among individual radiologists were consistently observed (p < 0.10). Differences in abnormality rates were nonsignificant for oil cysts, benign calcifications, and calcifications warranting biopsy. Scarring (p < 0.001) and masses requiring biopsy (p < 0.001) were more common in the reduction cohort. Breast Imaging Reporting and Data System scores were higher after breast reduction (p < 0.001). Significant differences in the recommended follow-up time were also seen (p < 0.01). CONCLUSIONS: : Compared with reduction mammaplasty, a widely accepted procedure, fat grafting to the breast produces fewer radiographic abnormalities with a more favorable Breast Imaging Reporting and Data System score and less aggressive follow-up recommendations by breast radiologists. CLINICAL QUESTION/LEVEL OF EVIDENCE: : Therapeutic, III.
BACKGROUND: : One issue in the adoption of autologous fat transfer to the breast is concern over mammographic changes that may obscure cancer detection. The authors compared mammographic changes following fat grafting to the breast with changes seen after breast reduction. METHODS: : Twenty-seven women who had normal preoperative mammograms were treated with fat grafting to the breast, including admixing of autologous adipose stem cells with the fat graft, for cosmetic augmentation. Repeated mammograms were performed 12 months after surgery. As a control group, postsurgical mammograms from 23 reduction mammaplasty patients were compared. Eight academic breast imaging radiologists reviewed each mammogram in a blinded fashion. Outcomes analysis accounting for individual radiologist's tendencies was performed using generalized estimating equations. RESULTS: : The average volume of fat injected per patient was 526.5 cc. Fifty mammograms (27 lipotransfer, 23 breast reduction) were assessed. Differences in interpretation among individual radiologists were consistently observed (p < 0.10). Differences in abnormality rates were nonsignificant for oil cysts, benign calcifications, and calcifications warranting biopsy. Scarring (p < 0.001) and masses requiring biopsy (p < 0.001) were more common in the reduction cohort. Breast Imaging Reporting and Data System scores were higher after breast reduction (p < 0.001). Significant differences in the recommended follow-up time were also seen (p < 0.01). CONCLUSIONS: : Compared with reduction mammaplasty, a widely accepted procedure, fat grafting to the breast produces fewer radiographic abnormalities with a more favorable Breast Imaging Reporting and Data System score and less aggressive follow-up recommendations by breast radiologists. CLINICAL QUESTION/LEVEL OF EVIDENCE: : Therapeutic, III.
Authors: Ross Dolan; Meera Patel; Eva Weiler-Mithoff; James Mansell; Sheila Stallard; Julie C Doughty; Laszlo Romics Journal: Breast Care (Basel) Date: 2015-08-21 Impact factor: 2.860
Authors: Michael T Chung; Jeong S Hyun; David D Lo; Daniel T Montoro; Masakazu Hasegawa; Benjamin Levi; Michael Januszyk; Michael T Longaker; Derrick C Wan Journal: Tissue Eng Part C Methods Date: 2013-01-04 Impact factor: 3.056