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Lipofilling in breast reconstruction not associated with increase in breast cancer recurrence

There was no significant difference in rates of breast cancer recurrences in breasts reconstructed with lipofilling compared with breasts reconstructed without lipofilling, according to recently published study results.

Researchers studied patients who underwent segmental or total mastectomy for breast cancer (719 breasts; cases) or for breast cancer risk reduction or benign disease (305 cancer-free breasts), followed by breast reconstruction using lipofilling as an adjunct or primary procedure from June 1981 through February 2014. A control cohort included patients with breast cancer treated with segmental or total mastectomy followed by reconstruction without lipofilling (670 breasts).

There was a 60-month mean follow-up for cases, 44 months for the control cohort and 73 months for the cancer-free breasts. Nine cases (1.3%) and 16 controls (2.4%) experienced locoregional recurrence (P = .455). There was no breast cancer development in the cancer-free breasts.

“The only subgroup examined in which lipofilling was associated with an increased risk of locoregional recurrence was the subgroup treated with hormonal therapy, 1.4% and 0.5% for lipofilling and no lipofilling, respectively (P = .038),” the researchers wrote.

The case cohort experienced a 1.6% cumulative 5-year logoregional recurrence rate, while the control cohort had a 4.1% recurrence rate for the time period. In addition, 2.4% of cases and 3.6% of controls experienced systemic recurrence (P = .514). Healthy breasts reconstructed with lipofilling experienced no primary breast cancer.

“The results of this study showed no increase in rates of locoregional recurrence, systemic recurrence or second breast cancer and support the oncologic safety of fat grafting in breast reconstruction,” the researchers concluded. “Although receipt of hormonal therapy did significantly increase the risk of locoregional recurrence of breast cancer in patients who received lipofilling compared with patients who did not receive lipofilling, the recurrence rates were low. Before withholding lipofilling as a reconstructive option for breast cancer patients receiving hormonal therapy, a randomized trial would most be appropriate to determine the true clinical significance.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.