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Annals of Surgical Oncology
Erschienen in: Annals of Surgical Oncology 3/2016

01.03.2016 | Breast Oncology

Evaluation of Oncological Safety of Fat Grafting After Breast-Conserving Therapy: A Prospective Study

verfasst von: Ondrej Mestak, MD, PhD, Veronika Hromadkova, MD, Monika Fajfrova, MD, Martin Molitor, MD, PhD, Jan Mestak, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 3/2016

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Abstract

Introduction

Breast-conserving treatment (BCT) consisting of a lumpectomy followed by radiation is considered the standard of care in early-stage breast cancer, and breast reconstruction using fat transfer has become the standard of care in these patients. Immediately following BCT, patients are theoretically the most prone for cancer recurrence caused by the remaining mass of glandular tissue. Therefore, we conducted a prospective study to evaluate the oncological safety of fat grafting in patients after BCT.

Methods

We analyzed patients who underwent breast reconstruction after BCT between April 2011 and February 2014. The control subjects were matched from a prospective database of women treated for breast cancer who did not undergo fat grafting, and each control was matched for the following variables: date of primary cancer surgery, date of fat grafting, histology, estrogen and progesterone receptors (ER+PR), adjuvant hormone therapy, disease-free interval from primary operation (BCT), and disease-free interval from breast reconstruction involving fat grafting. The primary endpoint of this study was tumor recurrence.

Results

The study group consisted of 32 patients, while the control group consisted of 45 patients. Breast tumor recurrence was observed in 2 of 32 cases (6.25 %) in the reconstruction group, and distant metastases were detected in both cases. In the control group without reconstruction, we found cancer recurrence in 2 of 41 cases (4.88 %), and locoregional recurrence was observed in both cases. The difference in cancer recurrence after BCT was insignificant between groups (p = 0.593).

Conclusion

The recurrence rate in patients reconstructed with fat grafts after BCT was not significantly different from the recurrence rate of control BCT patients.
Literatur
1.
Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), Darby S, McGale P, Correa C, Taylor C, Arriagada R, et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011;378(9804):1707–16.CrossRef
2.
Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347(16):1227–32.CrossRefPubMed
3.
Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347(16):1233–41.CrossRefPubMed
4.
Irwig L, Bennetts A. Quality of life after breast conservation or mastectomy: a systematic review. Aust N Z J Surg. 1997;67(11):750–4.CrossRefPubMed
5.
Asgeirsson KS, Rasheed T, McCulley SJ, Macmillan RD. Oncological and cosmetic outcomes of oncoplastic breast conserving surgery. Eur J Surg Oncol. 2005;31(8):817–23.CrossRefPubMed
6.
Johansen J, Overgaard J, Rose C, Engelholm SA, Gadeberg CC, Kjaer M, et al. Cosmetic outcome and breast morbidity in breast-conserving treatment: results from the Danish DBCG-82TM national randomized trial in breast cancer. Acta Oncol. 2002;41(4):369–80.CrossRefPubMed
7.
Kelly DA, Wood BC, Knoll GM, Chang SC, Crantford JC, Bharti GD, et al. Outcome analysis of 541 women undergoing breast conservation therapy. Ann Plast Surg. 2012;68(5):435–7.CrossRefPubMed
8.
Mestak O, Zimovjanová M. Breast reconstruction by autologous fat transfer [in Czech]. Rozhl Chir. 2012;91(7):373–7.PubMed
9.
Mestak O, Sukop A, Hsueh Y-S, Molitor M, Mestak J, Matejovska J, et al. Centrifugation versus PureGraft for fatgrafting to the breast after breast-conserving therapy. World J Surg Oncol. 2014;12(1):178.PubMedCentralCrossRefPubMed
10.
Rigotti G, Marchi A, Galie M, Baroni G, Benati D, Krampera M, et al. Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: a healing process mediated by adipose-derived adult stem cells. Plast Reconstr Surg. 2007;119(5):1409–22.CrossRefPubMed
11.
Coleman SR. Structural fat grafting: more than a permanent filler. Plast Reconstr Surg. 2006;118(3 Suppl):108S–20.CrossRefPubMed
12.
Lindroos B, Suuronen R, Miettinen S. The potential of adipose stem cells in regenerative medicine. Stem Cell Rev. 2011;7(2):269–91.CrossRefPubMed
13.
Alharbi Z, Opländer C, Almakadi S, Fritz A, Vogt M, Pallua N. Conventional vs. micro-fat harvesting: how fat harvesting technique affects tissue-engineering approaches using adipose tissue-derived stem/stromal cells. Br J Plast Surg. 2013;66(9):1271–8.
14.
Kucerova L, Kovacovicova M, Polak S, Bohac M, Fedeles J, Palencar D, et al. Interaction of human adipose tissue-derived mesenchymal stromal cells with breast cancer cells. Neoplasma. 2011;58(5):361–70.CrossRefPubMed
15.
Kucerova L, Skolekova S, Matuskova M, Bohac M, Kozovska Z. Altered features and increased chemosensitivity of human breast cancer cells mediated by adipose tissue-derived mesenchymal stromal cells. BMC Cancer. 2013;13(1):535.PubMedCentralCrossRefPubMed
16.
Rowan BG, Gimble JM, Sheng M, Anbalagan M, Jones RK, Frazier TP, et al. Human adipose tissue-derived stromal/stem cells promote migration and early metastasis of triple negative breast cancer xenografts. PLoS One. 2014;9(2):e89595.PubMedCentralCrossRefPubMed
17.
Zimmerlin L, Donnenberg AD, Rubin JP, Basse P, Landreneau RJ, Donnenberg VS. Regenerative therapy and cancer: in vitro and in vivo studies of the interaction between adipose-derived stem cells and breast cancer cells from clinical isolates. Tissue Eng Part A. 2011;17(1-2):93–106.PubMedCentralCrossRefPubMed
18.
Zhao M, Dumur CI, Holt SE, Beckman MJ, Elmore LW. Multipotent adipose stromal cells and breast cancer development: think globally, act locally. Mol Carcinog. 2010;49(11):923–7.PubMedCentralCrossRefPubMed
19.
Albarenque SM, Zwacka RM, Mohr A. Both human and mouse mesenchymal stem cells promote breast cancer metastasis. Stem Cell Res. 2011;7(2):163–71.CrossRefPubMed
20.
Babovic S. Complete breast reconstruction with autologous fat graft: a case report. J Plast Reconstr Aesthet Surg. 2010;63(7):e561–3.CrossRefPubMed
21.
Delay E, Garson S, Tousson G, Sinna R. Fat injection to the breast: technique, results, and indications based on 880 procedures over 10 years. Aesthet Surg J. 2009;29(5):360–76.CrossRefPubMed
22.
Chan CW, McCulley SJ, Macmillan RD. Autologous fat transfer: a review of the literature with a focus on breast cancer surgery. J Plast Reconstr Aesthet Surg. 2008;61(12):1438–48.CrossRefPubMed
23.
Panettiere P, Accorsi D, Marchetti L, Sgro F, Sbarbati A. Large-breast reconstruction using fat graft only after prosthetic reconstruction failure. Aesthet Plast Surg. 2011;35(5):703–8.CrossRef
24.
Salgarello M, Visconti G, Farallo E. Autologous fat graft in radiated tissue prior to alloplastic reconstruction of the breast: report of two cases. Aesthet Plast Surg. 2009;34(1):5–10.CrossRef
25.
Chaput B, Grolleau JL, Bertheuil N, Eburdery H, Chavoin JP, Garrido I. Another suspected case of breast cancer recurrence after lipofilling? Remain cautious. J Plast Reconstr Aesthet Surg. 2014;67(8):1156–7.CrossRefPubMed
26.
Chaput B, Foucras L, Le Guellec S, Grolleau JL, Garrido I. Recurrence of an invasive ductal breast carcinoma 4 months after autologous fat grafting. Plast Reconstr Surg. 2013;131(1):123e–4.CrossRefPubMed
27.
Rigotti G, Marchi A, Stringhini P, Baroni G, Galie M, Molino AM, et al. Determining the oncological risk of autologous lipoaspirate grafting for post-mastectomy breast reconstruction. Aesthet Plast Surg. 2010;34(4):475–80.CrossRef
28.
Donnenberg VS, Zimmerlin L, Rubin JP, Donnenberg AD. Regenerative therapy after cancer: what are the risks? Tissue Eng Part B Rev. 2010;16(6):567–75.PubMedCentralCrossRefPubMed
29.
Fraser JK, Hedrick MH, Cohen SR. Oncologic risks of autologous fat grafting to the breast. Aesthet Surg J. 2011;31(1):68–75.CrossRefPubMed
30.
De Lorenzi F, Lohsiriwat V, Petit JY. In response to: Rigotti G, Marchi A, Stringhini P, et al. Determining the oncological risk of autologous lipoaspirate grafting for post-mastectomy breast reconstruction. Aesth Plast Surg. 2011;35(1):132–3.CrossRef
31.
Rietjens M, De Lorenzi F, Rossetto F, Brenelli F, Manconi A, Martella S, et al. Safety of fat grafting in secondary breast reconstruction after cancer. J Plast Reconstr Aesthet Surg. 2011;64(4):477–83.CrossRefPubMed
32.
Petit JY, Botteri E, Lohsiriwat V, Rietjens M, De Lorenzi F, Garusi C, et al. Locoregional recurrence risk after lipofilling in breast cancer patients. Ann Oncol. 2012;23(3):582–8.CrossRefPubMed
33.
Petit JY, Lohsiriwat V, Clough KB, Sarfati I, Ihrai T, Rietjens M, et al. The oncologic outcome and immediate surgical complications of lipofilling in breast cancer patients: a multicenter study–Milan-Paris-Lyon experience of 646 lipofilling procedures. Plast Reconstr Surg. 2011;128(2):341–6.CrossRefPubMed
34.
Lampert FM, Grabin S, Stark GB. The RESTORE-2 trial: proof of safety and efficacy of “regenerative-cell enriched” fat-grafting? Eur J Surg Oncol. 2012;38(12):1231–2.CrossRefPubMed
35.
Krastev TK, Jonasse Y, Kon M. Oncological safety of autologous lipoaspirate grafting in breast cancer patients: a systematic review. Ann Surg Oncol. 2013;20(1):111–9.CrossRefPubMed
36.
Petit JY, Rietjens M, Botteri E, Rotmensz N, Bertolini F, Curigliano G, et al. Evaluation of fat grafting safety in patients with intraepithelial neoplasia: a matched-cohort study. Ann Oncol. 2013;24(6):1479–84.CrossRefPubMed
37.
Krumboeck A, Pietro Giovanoli, Plock JA. Fat grafting and stem cell enhanced fat grafting to the breast under oncological aspects: recommendations for patient selection. Breast. 2013;22(5):579–84.CrossRefPubMed
38.
Gale KL, Rakha EA, Ball G, Tan V, McCulley SJ, Macmillan RD. A case controlled study of the oncological safety of fat grafting. Plast Reconstr Surg. 2015;135(5)1263–75.CrossRef
39.
Brenelli F, Rietjens M, De Lorenzi F, Pinto-Neto A, Rossetto F, Martella S, et al. Oncological safety of autologous fat grafting after breast conservative treatment: a prospective evaluation. Breast J. 2014;20(2):159–65.CrossRefPubMed
40.
Rubin JP, Coon D, Zuley M, Toy J, Asano Y, Kurita M, et al. Mammographic changes after fat transfer to the breast compared with changes after breast reduction: a blinded study. Plast Reconstr Surg. 2012;129(5):1029–38.CrossRefPubMed
41.
Veber M, Tourasse C, Toussoun G, Moutran M, Mojallal A, Delay E. Radiographic findings after breast augmentation by autologous fat transfer. Plast Reconstr Surg. 2011;127(3):1289–99.CrossRefPubMed
42.
Illouz YG, Sterodimas A. Autologous fat transplantation to the breast: a personal technique with 25 years of experience. Aesthet Plast Surg. 2009;33(5):706–15.CrossRef
43.
Lohsiriwat V, Curigliano G, Rietjens M, Goldhirsch A, Petit JY. Autologous fat transplantation in patients with breast cancer: “silencing” or “fueling” cancer recurrence? Breast. 2011;20(4):351–7.CrossRefPubMed
44.
Wang Y-Y, Lehuédé C, Laurent V, Dirat B, Dauvillier S, Bochet L, et al. Adipose tissue and breast epithelial cells: a dangerous dynamic duo in breast cancer. Cancer Lett. 2012;324(2):142–51.CrossRefPubMed
45.
Pearl RA, Leedham SJ, Pacifico MD. The safety of autologous fat transfer in breast cancer: lessons from stem cell biology. J Plast Reconstr Aesthet Surg. 2012;65(3):283–8.CrossRefPubMed
46.
Dieudonne M-N, Bussiere M, Santos Dos E, Leneveu M-C, Giudicelli Y, Pecquery R. Adiponectin mediates antiproliferative and apoptotic responses in human MCF7 breast cancer cells. Biochem Biophys Res Commun. 2006;345(1):271–9.CrossRefPubMed
47.
Sun B, Roh KH, Park JR, Lee SR, Park SB, Jung JW, et al. Therapeutic potential of mesenchymal stromal cells in a mouse breast cancer metastasis model. Cytotherapy. 2009;11(3):289–98.CrossRefPubMed
Metadaten
Titel
Evaluation of Oncological Safety of Fat Grafting After Breast-Conserving Therapy: A Prospective Study
verfasst von
Ondrej Mestak, MD, PhD
Veronika Hromadkova, MD
Monika Fajfrova, MD
Martin Molitor, MD, PhD
Jan Mestak, MD, PhD
Publikationsdatum
01.03.2016
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 3/2016
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4908-2

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