Oncologic safety of immediate autologous fat grafting for reconstruction in breast-conserving surgery.

Autor: Stumpf CC; Postgraduate Program in Health Sciences: Gynecology and Obstetrics, Medical School, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro 2350/600C, Porto Alegre, RS, 90035-903, Brazil. dra.camilestumpf@gmail.com., Zucatto ÂE; Mastology Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil., Cavalheiro JAC; Mastology Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil., de Melo MP; Mastology Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil., Cericato R; Mastology Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil., Damin APS; Postgraduate Program in Health Sciences: Gynecology and Obstetrics, Medical School, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro 2350/600C, Porto Alegre, RS, 90035-903, Brazil.; Department of Gynecology and Obstetrics, Medical School, UFRGS, Porto Alegre, RS, Brazil.; Mastology Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil., Biazús JV; Postgraduate Program in Health Sciences: Gynecology and Obstetrics, Medical School, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro 2350/600C, Porto Alegre, RS, 90035-903, Brazil.; Department of Gynecology and Obstetrics, Medical School, UFRGS, Porto Alegre, RS, Brazil.; Mastology Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
Jazyk: angličtina
Zdroj: Breast cancer research and treatment [Breast Cancer Res Treat] 2020 Apr; Vol. 180 (2), pp. 301-309. Date of Electronic Publication: 2020 Feb 06.
DOI: 10.1007/s10549-020-05554-0
Abstrakt: Importance: Autologous fat grafting (AFG), or lipofilling, has been used for immediate reconstruction at the time of breast-conserving surgery in order to achieve a satisfactory cosmetic outcome in patients with breast cancer and an unfavorable tumor-to-breast volume ratio or unfavorable tumor location. However, the oncologic safety of this technique is still unclear.
Objective: To determine whether AFG performed simultaneously with breast-conserving surgery is associated with differences in local relapse rates and disease-free survival.
Design: Matched retrospective cohort study.
Setting: Tertiary referral center.
Participants: Patients undergoing breast-conserving surgery with or without AFG between 2004 and 2016 were retrospectively enrolled and matched for age, staging, grade, tumor histology, and tumor immunohistochemical profile.
Main Outcome(s) and Measure(s): The cumulative incidence of locoregional recurrence (LRR) and disease-free survival were the primary end points, while distant recurrence and overall survival were the secondary end points.
Results: A total of 320 patients were followed. Cases were matched with controls at a 1:4 ratio. There was no difference in LRR or distant recurrence of breast cancer between the two groups. The annual LRR rate was 0.86% in patients who received immediate AFG vs. 0.7% in patients undergoing breast-conserving surgery alone (p ≥ 0.05). Number of lymph nodes was the sole independent risk factor for local recurrence (p = 0.045). No significant differences in disease-free survival rates were found between the groups.
Conclusions and Relevance: At a mean follow-up of 5 years, no significant differences in locoregional recurrence rates were found between patients who received immediate AFG and those who underwent breast-conserving surgery alone. These findings corroborate previous research demonstrating the oncological safety of immediate AFG reconstruction, further suggesting that this technique as a safe, effective way to achieve optimal cosmetic outcomes in primary breast cancer surgery without jeopardizing oncologic outcomes.
Databáze: MEDLINE
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