Krishna S Vyas1, Ryan C DeCoster, Jack C Burns2, Louis T Rodgers3, Max A Shrout4, James P Mercer3, Cristin Coquillard5, Adam J Dugan6, Michael D Baratta7, Brian D Rinker7, Henry C Vasconez2. 1. From the Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, MN. 2. Division of Plastic and Reconstructive Surgery. 3. College of Medicine MD/PhD program, University of Kentucky, Lexington, KY. 4. Division of Plastic and Reconstructive Surgery, Mayo Clinic, Phoenix, AZ. 5. Division of Plastic and Reconstructive Surgery, Case Western Reserve University, Cleveland, OH. 6. Department of Biostatistics, University of Kentucky, Lexington, KY. 7. Division of Plastic and Reconstructive Surgery, Mayo Clinic, Jacksonville, FL.
Abstract
INTRODUCTION: Autologous fat grafting (AFG) is a popular and effective method of breast reconstruction after mastectomy; however, the oncological safety of AFG remains in question. The aim of this study was to determine whether AFG increases the risk of cancer recurrence in the reconstructed breast. METHODS: A matched, case-control study was conducted from 2000 to 2017 at the senior author's institution. Inclusion was limited to female patients who underwent mastectomy and breast reconstruction with or without AFG. Data were further subdivided at the breast level. χ analyses were used to test the association between AFG status and oncologic recurrence. A Cox proportional-hazards model was constructed to assess for possible differences in time to oncologic recurrence. The probability of recurrence was determined by Kaplan-Meier analyses and confirmed with log-rank testing. RESULTS: Overall, 428 breasts met study criteria. Of those, 116 breasts (27.1%) received AFG, whereas 312 (72.9%) did not. No differences in the rates of oncologic recurrence were found between the groups (8.2% vs 9.0%, P < 1.000). Unadjusted (hazard ratio = 1.03, confidence interval = 0.41-2.60, P < 0.957) and adjusted hazard models showed no statistically significant increase in time to oncologic recurrence when comparing AFG to non-AFG. In addition, no statistical differences in disease-free survival were found (P = 0.96 by log rank test). CONCLUSION: Autologous fat grafting for breast reconstruction is oncologically safe and does not increase the likelihood of oncologic recurrence. Larger studies (eg, meta analyses) with longer follow-up are needed to further elucidate the long-term safety of AFG as a reconstructive adjunct.
INTRODUCTION: Autologous fat grafting (AFG) is a popular and effective method of breast reconstruction after mastectomy; however, the oncological safety of AFG remains in question. The aim of this study was to determine whether AFG increases the risk of cancer recurrence in the reconstructed breast. METHODS: A matched, case-control study was conducted from 2000 to 2017 at the senior author's institution. Inclusion was limited to female patients who underwent mastectomy and breast reconstruction with or without AFG. Data were further subdivided at the breast level. χ analyses were used to test the association between AFG status and oncologic recurrence. A Cox proportional-hazards model was constructed to assess for possible differences in time to oncologic recurrence. The probability of recurrence was determined by Kaplan-Meier analyses and confirmed with log-rank testing. RESULTS: Overall, 428 breasts met study criteria. Of those, 116 breasts (27.1%) received AFG, whereas 312 (72.9%) did not. No differences in the rates of oncologic recurrence were found between the groups (8.2% vs 9.0%, P < 1.000). Unadjusted (hazard ratio = 1.03, confidence interval = 0.41-2.60, P < 0.957) and adjusted hazard models showed no statistically significant increase in time to oncologic recurrence when comparing AFG to non-AFG. In addition, no statistical differences in disease-free survival were found (P = 0.96 by log rank test). CONCLUSION: Autologous fat grafting for breast reconstruction is oncologically safe and does not increase the likelihood of oncologic recurrence. Larger studies (eg, meta analyses) with longer follow-up are needed to further elucidate the long-term safety of AFG as a reconstructive adjunct.
Authors: Christodoulos Kaoutzanis; Minqiang Xin; Tiffany N S Ballard; Kathleen B Welch; Adeyiza O Momoh; Jeffrey H Kozlow; David L Brown; Paul S Cederna; Edwin G Wilkins Journal: Ann Plast Surg Date: 2016-03 Impact factor: 1.539
Authors: Claudio Silva-Vergara; Joan Fontdevila; Omar Weshahy; Marta Yuste; Jordi Descarrega; Luis Grande Journal: Ann Plast Surg Date: 2017-09 Impact factor: 1.539