Lipofilling may be done after breast reconstruction to fix small asymmetry issues or defects in the shape or balance of the breast compared to the other breast. Fat tissue is removed from another part of the body, the abdomen, for example, processed into liquid in a lab, and then injected into the reconstructed breast to improve its shape or fullness.
Lipofilling is rarely done in the United States and is more common in Europe. Some doctors wondered if women who had lipofilling would have a higher risk of breast cancer coming back (recurring).
European research published in the Annals of Oncology suggests that women who have lipofilling after breast cancer surgery and reconstruction are no more likely to have the cancer come back than women who never had lipofilling.
The researchers compared 321 women who had lipofilling and 642 similar women who didn't have lipofilling. All the women had been diagnosed with early-stage breast cancer and had mastectomy or lumpectomy. The women who had lipofilling had it a little more than 2 years (26 months) after breast cancer surgery.
The following numbers of women had a local recurrence (cancer in the breast area where the original cancer was diagnosed) during follow-up:
- 9 of the 321 women who had lipofilling
- 19 of the 642 women who didn't have lipofilling
The numbers suggest that local breast cancer recurrence is no more likely in women who have lipofilling compared to women who don't. Still, the study was retrospective, which means researchers looked at the medical histories of women who did or didn't have lipofilling in the past.
A prospective study, one that randomly assigns women to have or not have lipofilling and then carefully follows how they do over an extended period of time would give women and doctors more confidence about the safety of lipofilling.
Although this study didn't find a link between lipofilling and breast cancer recurrence, some doctors have other concerns about lipofilling. The injected fat can break down (necrosis) or cause a cyst to form in the area where the fat was injected. Both of these situations may cause abnormalities in the breast area that may be mistaken for cancer.
Breast reconstruction during or after surgery to remove breast cancer (mastectomy or lumpectomy) is an important option that ALL women should discuss with their doctors BEFORE breast cancer surgery. Not all women want breast reconstruction after breast cancer surgery. Reconstruction is a very personal choice -- you need to decide what's best for you and your unique situation. In the United States, about 75% of women who have mastectomy also have one or both breasts reconstructed.
If you've already had a mastectomy or lumpectomy and you and your doctor didn't discuss reconstruction beforehand, you can still talk to your doctor about breast reconstruction. You may decide not to have reconstruction, but it can be helpful to consider all your options. If your surgeon doesn't bring up reconstruction, ask for more information and a referral.
If you've already had reconstruction and aren't satisfied with the results, ask your doctor about options that might help and whether lipofilling is one of those options.