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Long-Term Results Suggest Fat Grafting Does Not Increase Recurrence Risk

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Fat grafting, also called autologous fat transfer, is a newer breast reconstruction technique. In fat grafting, fat tissue is removed from other parts of your body -- usually your thighs, belly, and buttocks -- by liposuction. The tissue is then processed into liquid and injected into the breast area to recreate the breast.

A study with an average follow-up of 5 years supports earlier, short-term results suggesting fat grafting reconstruction does not increase the risk of breast cancer recurrence (the cancer coming back) compared to more traditional reconstruction techniques, such as autologous reconstruction or using an implant.

The research was published online on Oct. 10, 2018, by the journal JAMA Surgery. Read the abstract of “Long-term Follow-up of Autologous Fat Transfer vs Conventional Breast Reconstruction and Association With Cancer Relapse in Patients With Breast Cancer.”

Fat grafting vs. conventional reconstruction recurrence rates

This Dutch study included 587 women who had been diagnosed with breast cancer and had mastectomy and breast reconstruction between 2006 and 2014. The researchers reviewed the medical records of women who had fat grafting reconstruction and matched them to a similar woman who had more traditional reconstruction.

Overall, 287 women had fat grafting reconstruction (300 breasts were affected) and 300 women had traditional reconstruction.

The women who had fat grafting reconstruction were followed for an average of 9.3 years, which included 5 years after reconstruction. Women who had traditional reconstruction were followed for an average of 8.6 years from their first reconstruction surgery.

Overall, the rates of breast cancer recurrence were similar between the two groups:

  • 8 women who had fat grafting reconstruction had a recurrence.
  • 11 women who had traditional reconstruction had a recurrence.

While the results of this study are very encouraging, it’s important to know that this study was small and had some limitations.

"There is an urgent need to investigate whether autologous fat transfer could potentially compromise the oncologic safety in patients with breast cancer, before a false sense of security promotes wide adoption in clinical practice," the researchers wrote.

More research is needed before fat grafting is used widely for breast reconstruction.

Deciding whether to have a breast reconstructed after surgery to remove breast cancer is a very personal choice. If you’ve been diagnosed with breast cancer and are planning your surgery, you may decide not to have reconstruction, but it can be helpful to consider all your options.

Things to consider when making decisions about breast reconstruction

Here are some questions you might want to think about as you're making your decision about breast reconstruction:

  • Is it important to you to have a permanent breast shape? Some women prefer to wear a prosthesis instead of having reconstruction.
  • Is it important to you that your breasts look balanced when wearing a bra and bathing suits? Though you'll be able to see the difference between the rebuilt breast and your other breast when you're naked, reconstruction usually looks very natural when you're wearing a bra or bathing suit.
  • In your unique situation, will breast reconstruction involve several surgeries over a long period of time? For many women, the answer is yes.
  • Will your insurance pay for all the reconstruction procedures? Find out what your insurance company will cover.
  • Did you have a lumpectomy that gave your breast a very different shape than it originally had? If you had a large portion of tissue removed, you might want to have reconstruction to restore a more balanced look.
  • Do you have any other medical conditions that might affect your ability to heal after surgery? If you have diabetes, circulatory problems, or a bleeding disorder, it may take your body longer to heal from reconstruction surgery than someone who doesn't have these conditions.
  • Do you have a condition that might give you a distorted image of your body? If you've been diagnosed with anorexia or bulimia, you may have a hard time accepting how your body looks in general, which may make it hard to accept how your reconstructed breast looks.

For more information, including types of reconstruction, the timing of reconstruction, and questions to ask your breast surgeon and plastic surgeon, visit the Breast Reconstruction section.

To talk to other women facing reconstruction decisions, join the Discussion Board forum Breast Reconstruction.

Written by: Jamie DePolo, senior editor

Reviewed by: Brian Wojciechowski, M.D., medical adviser

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