L R Khan1, C R Raine2, J M Dixon3. 1. Edinburgh Breast Unit, NHS Lothian, Western General Hospital, Edinburgh, UK. Electronic address: lucykhan@doctors.org.uk. 2. Edinburgh Breast Unit, NHS Lothian, Western General Hospital, Edinburgh, UK. Electronic address: cameron.raine@nhslothian.scot.nhs.uk. 3. Edinburgh Breast Unit, NHS Lothian, Western General Hospital, Edinburgh, UK. Electronic address: mike.dixon@ed.ac.uk.
Abstract
BACKGROUND: The aim of breast conserving surgery (BCS) is to excise the cancer with clear margins whilst at the same time leaving a good or excellent cosmetic result. A significant percentage of women, who have large cancers or have limited breast volumes, achieve poor cosmetic outcomes. BCS with immediate volume replacement using lipofilling or autologous fat transfer is a new technique. The aim of this study was to evaluate the cosmetic outcomes of a pilot study of patients having BCS and immediate lipofilling performed in The Edinburgh Breast Unit. METHODS: Questionnaires were mailed to 35 women who had BCS with immediate lipofilling and completed by 32 and results compared with those from a contemporary series of 39 women who had BCS alone. The cancers were significantly larger in the lipofilling group (median 21 mm vs. 16 mm p = 0.011) and the patients were non-significantly younger (median age 49 years vs. 54 p = 0.06). RESULTS: At a median follow-up of 36 months, results from the Breast Q™ questionnaire showed significantly better cosmetic outcomes with lipofilling (most p < 0.001) and less local breast symptoms (p = 0.0045). There have been no local recurrences in either group and only 1 of the 35 patients was recalled following post-operative surveillance annual mammography. CONCLUSION: BCS and immediate lipofilling provides superior cosmetic outcomes to standard BCS.
BACKGROUND: The aim of breast conserving surgery (BCS) is to excise the cancer with clear margins whilst at the same time leaving a good or excellent cosmetic result. A significant percentage of women, who have large cancers or have limited breast volumes, achieve poor cosmetic outcomes. BCS with immediate volume replacement using lipofilling or autologous fat transfer is a new technique. The aim of this study was to evaluate the cosmetic outcomes of a pilot study of patients having BCS and immediate lipofilling performed in The Edinburgh Breast Unit. METHODS: Questionnaires were mailed to 35 women who had BCS with immediate lipofilling and completed by 32 and results compared with those from a contemporary series of 39 women who had BCS alone. The cancers were significantly larger in the lipofilling group (median 21 mm vs. 16 mm p = 0.011) and the patients were non-significantly younger (median age 49 years vs. 54 p = 0.06). RESULTS: At a median follow-up of 36 months, results from the Breast Q™ questionnaire showed significantly better cosmetic outcomes with lipofilling (most p < 0.001) and less local breast symptoms (p = 0.0045). There have been no local recurrences in either group and only 1 of the 35 patients was recalled following post-operative surveillance annual mammography. CONCLUSION: BCS and immediate lipofilling provides superior cosmetic outcomes to standard BCS.