Journal time! The November 2012 issue of Plastic and Reconstructive Surgery Journal had an article on “Long Term Outcomes following Fat Grafting in Prosthetic Breast Reconstruction: A Comparative Analysis.” (Get all that?) In English: They looked at breast cancer reconstruction patients who were reconstructed with implants. Many of these women had fat transfer to the breast in addition to help make the implant reconstruction look better. The question: Did the transferred fat cause breast cancer?
Their answer: No. “Fat grafting after breast reconstruction does not adversely affect local tumor recurrence or surival on long term follow up. Autologous fat grafting can be used as an aesthetic adjunct to prosthetic reconstruction with minimal complications.”
So why the study? Fat transfer to the breast is a growing field. Fat is a great tool in our plastic surgery toolbox to make breasts look better. I use it in my breast cancer patients to help the cosmetic result of their reconstruction. It can make thin tissue coverage thicker; it can hide rippling and wrinkling; it can add volume to the upper part of the breast to create better cleavage; and it can fill in small defects. We plastic surgeons love the idea of using fat to replace fat- replacing “like with like.”
There have been some suggestions in the past that maybe fat cells and their associated factors could stimulate tumor growth and progression or could turn malignant.
This study reviewed 886 consecutive patients. 90 reconstructed breasts were found to have some kind of fat transfer used in reconstruction. The two groups (fat transfer vs. no fat transfer) were similar in demographics. The groups were stratified for cancer stage. Again, no differences were found between the groups in local recurrence or survival.
The authors do state for definitive understanding, a prospective multicenter trial could be done. For now, they state “We encourage reconstructive breast surgeons to continue to utilize fat grafting with careful oncologic follow up and to report their experience in the scientific literature when possible.”