Lipofilling Doesn’t Increase Recurrence Risk

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Lipofilling (also called fat grafting) is often used to fix minor flaws after breast reconstruction. In lipofilling, fat tissue is removed from another part of your body -- your abdomen, for example -- processed into liquid in a lab, and then injected into the reconstructed breast to improve its shape or fullness. It’s often used for things like softening and improving the skin over an implant, filling in imperfections, or giving more lift to a flap reconstruction.

Some doctors have wondered if lipofilling would increase the risk of breast cancer coming back (recurrence). Research done in 2011 suggested that women who have lipofilling are no more likely to have a recurrence than women who never had lipofilling.

A 2016 study adds more evidence that lipofilling doesn’t increase recurrence risk.

The study was published in the February 2016 issue of the journal Plastic and Reconstructive Surgery. Read “Lipofilling of the Breast Does Not Increase the Risk of Recurrence of Breast Cancer: A Matched Controlled Study.”

In the study, the researchers identified more than 1,024 women who had had mastectomy and then breast reconstruction that included lipofilling:

  • 719 of the women had mastectomy to remove breast cancer
  • 305 women were at high-risk for breast cancer but hadn’t been diagnosed and had preventive mastectomy surgery to reduce risk

The researchers had information on the BRCA status of 233 of the 305 high-risk women -- 33 of the women had an abnormal BRCA1 or BRCA2 gene.

The researchers then compared rates of recurrent or new cancers between the 1,024 women who had reconstruction using lipofilling and 670 women who had mastectomy to remove breast cancer who had reconstruction without lipofilling.

The women who had lipofilling were followed for about 5 years and the women who didn’t have lipofilling were followed for about 4 years.

Compared to women who didn’t have lipofilling, women who did have lipofilling were more likely to have:

  • stage 0 or stage I disease (61.2% vs. 48.1%)
  • HER2-negative disease (93.6% vs. 88.4%)
  • been treated with hormonal therapy (60.4% vs. 55.4%)

Women who didn’t have lipofilling were more likely to have chemotherapy (70.3% vs. 61.2%).

Overall, recurrence rates were very similar for all the women whether they had lipofilling or not.

Locoregional recurrence (cancer coming back in the breast area) rates were:

  • 1.3% for women who had lipofilling
  • 2.4% for women who didn’t have lipofilling

Distant recurrence rates (cancer coming back in an area of the body away from the breast, such as the bones or liver) were:

  • 2.4% for women who had lipofilling
  • 3.6% for women who didn’t have lipofilling

The researchers also looked at the recurrence rates between lipofilling vs. no lipofilling among women grouped by:

  • cancer stage
  • hormone-receptor status of the cancer
  • area in the breast where the cancer was located
  • use of chemotherapy
  • use of radiation therapy

There was no difference in recurrence rates between lipofilling and no lipofilling for any of these groups.

However, when the researchers looked at women who were treated with hormonal therapy, women who had lipofilling had a slightly higher risk of recurrence. Recurrence rates were:

  • 1.4% for women treated with hormonal therapy who had lipofilling
  • 0.5% for women treated with hormonal therapy who didn’t have lipofilling

This difference was statistically significant, which means that it was likely due to the difference in lipofilling and not just because of chance.

"Our controlled study shows that, used as part of breast reconstruction, lipofilling is a safe procedure that does not increase the risk of recurrent or new breast cancers," said Steven J. Kronowitz, M.D., of Kronowitz Plastic Surgery and lead author of the study. Dr. Kronowitz used to be a faculty member at the University of Texas MD Anderson Cancer Center.

Dr. Kronowitz said that he hoped that these results will encourage more plastic surgeons to use lipofilling to provide the best possible results of breast reconstruction for their patients undergoing breast cancer surgery.

If you’ve had mastectomy -- either to remove cancer or to reduce your risk of breast cancer -- and reconstruction, it’s important to give the reconstructed breast time to heal, about 4 to 6 months, before you judge the results. Still, after that time you may have a small difference in the shape, balance, or position of the reconstructed breast compared to the other breast.

Lipofilling is just one technique that your doctor may recommend to fix any minor flaws. If that’s the approach recommended for you, you can feel confident that the option is safe and effective.

To learn more about breast reconstruction and other ways to fix minor flaws after reconstruction surgery, visit the Breastcancer.org Breast Reconstruction pages.



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