Oncological Safety of Lipofilling in Patients with Breast Cancer: A Metaanalysis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hebatullah Yasser Badr Mahmoud ◽  
Hany Saad Setta ◽  
Mohamed El-Shinawi

Abstract Background Lipofilling is an increasingly popular technique for breast reconstruction following both mastectomy and breast-conserving surgery (BCS). Autologous fat transfer (Lipofilling), is a technique which has been used for many years in the setting of aesthetic breast surgery. Although gaining popularity in this setting, there are still questions regarding its oncological safety when used in patients being treated for breast cancer. Objective To systematically evaluate the current literature regarding the oncological safety of lipofilling in patients who underwent surgical treatment for breast cancer by performing a metaanalysis to investigate the recurrence rates and the incidence of complications after lipofilling. Data Sources: Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materi als available in the Internet till 2019. Data Extraction All the studies which did not fulfill the inclusion criteria were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures. Conclusion Through this analysis, no evidence that lipofilling significantly increases the risk of locoregional recurrence when used as part of a breast reconstruction procedure after either mastectomy or BCS for breast cancer was found. Therefore, it can be considered an oncologically safe procedure in suitable patients with careful oncological follow-up. In the future, more longterm, adequately powered, multicentre controlled studies are needed. Additionally, more research should be carried out on the incidence of complications following lipofilling so that efforts can be made to prevent them and optimise fat graft survival.

2013 ◽  
Vol 154 (5) ◽  
pp. 163-171 ◽  
Author(s):  
László Romics jr. ◽  
Sheila Stallard ◽  
Eva Weiler-Mithoff

Introduction: Oncological safety of skin-sparing mastectomy followed by immediate breast reconstruction is widely debated. Current evidence is relatively poor since it is based mostly on short-term follow-up data of highly selected patient populations. Aim: Recurrence rates of a large cohort of non-selected patients, i. e. “all-comers” were analyzed during a 10-year follow up. Methods: Patient records and follow-up data of 253 consecutive cases treated with of skin-sparing mastectomy and immediate breast reconstruction between 1995 and 2000 were studied. During this time period “all-comers” policy was applied, which meant that all patients treated with mastectomy were offered immediate breast reconstruction regardless of tumour stage. Results: “All-comers” approach resulted in a large proportion of patients with more advanced disease. During the 112 months mean follow-up 8.2% locoregional, 2.9% local, 10.6% distal and 18.8% overall recurrence rates were detected. Breast cancer specific survival rate was 90.9%. Autologous breast reconstruction was applied more frequently in patients with higher tumour stage; therefore recurrence rate was higher compared to patients undergoing implant-based reconstruction. Conclusion: Based on these long-term follow-up data skin-sparing mastectomy combined with immediate breast reconstruction is an oncologically safe treatment option. Therefore, application of “all-comers” policy for breast cancer patients treated with skin-sparing mastectomy followed by immediate breast reconstruction is feasible. Orv. Hetil., 2013, 154, 163–171.


2016 ◽  
Vol 103 (4) ◽  
pp. 391-398 ◽  
Author(s):  
S. M. Beecher ◽  
D. P. O'Leary ◽  
R. McLaughlin ◽  
K. J. Sweeney ◽  
M. J. Kerin

Breast Care ◽  
2018 ◽  
Vol 14 (3) ◽  
pp. 165-169
Author(s):  
Aylin Kümmel ◽  
Sherko Kümmel ◽  
Jens-Uwe Blohmer ◽  
Andree Faridi ◽  
Ulrike Nitz ◽  
...  

Background: Autologous fat transfer in breast reconstruction has become increasingly important in breast reconstructive surgery. Although the indication to obtain fat, the various operative procedures, and the risks for the patient have been addressed in a large number of studies, detailed information on the everyday use of autologous lipotransfer in breast units in Germany is still lacking. Methods: The objective of the study was to obtain primary data on the use of autologous lipotransfer to treat breast cancer patients in Germany and to determine measures for quality assurance in the daily practice. An online questionnaire concerning breast cancer and lipofilling was sent to specialists in gynecology and plastic surgery. Results: Two-thirds of the specialists who responded to the questionnaire use autologous lipotransfer for breast reconstruction and did not report an increase of local recurrence following lipotransfer. There were only small differences between gynecologists and plastic surgeons regarding the procedure and indication for lipotransfer. The method is highly accepted by patients and physicians, and both gynecologists and plastic surgeons rated the improvement achieved through lipofilling as ‘high'. Conclusions: The lack of randomized controlled data, especially in high-risk patients, demonstrates the necessity for a registry study on this topic. Our survey describes, in detail, the indications for lipofilling as well as its appropriate application in breast cancer patients in Germany and may thereby reduce the present therapeutic uncertainties.


BMC Cancer ◽  
2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Joachim Geers ◽  
Hans Wildiers ◽  
Katrien Van Calster ◽  
Annouschka Laenen ◽  
Giuseppe Floris ◽  
...  

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Grant W. Carlson

Skin sparing mastectomy has resulted in marked improvement in the aesthetic results of immediate breast reconstruction. Mature data has confirmed its oncological safety in the treatment of breast cancer. The procedure has gained wide acceptance and has undergone numerous technical advances since its introduction over twenty years ago. Careful patient selection and choice of skin incisions are necessary to avoid complications.


2019 ◽  
Vol 144 (2) ◽  
pp. 169e-177e ◽  
Author(s):  
Charalampos Siotos ◽  
Androniki Naska ◽  
Ricardo J. Bello ◽  
Akachimere Uzosike ◽  
Philippos Orfanos ◽  
...  

2019 ◽  
Vol 45 (10) ◽  
pp. 1827-1834 ◽  
Author(s):  
Luca Sorrentino ◽  
Lea Regolo ◽  
Elisabetta Scoccia ◽  
Gianfranco Petrolo ◽  
Daniela Bossi ◽  
...  

2018 ◽  
Vol 105 (9) ◽  
pp. 1082-1097 ◽  
Author(s):  
T. K. Krastev ◽  
S. J. Schop ◽  
J. Hommes ◽  
A. A. Piatkowski ◽  
E. M. Heuts ◽  
...  

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. 11022-11022 ◽  
Author(s):  
Suzanne M Beecher ◽  
Donal Peter O'leary ◽  
Carmel Malone ◽  
Ray McLaughlin ◽  
Karl Sweeney ◽  
...  

2018 ◽  
Vol 4 (1) ◽  
Author(s):  
Muhammad Asad Parvaiz ◽  
Nicola Roche ◽  
Jennifer Rusby ◽  
Steven Goh ◽  
Tapan Sircar

Oncoplastic surgery (OPS) of the breast has revolutionised the surgical practice in the past few years worldwide and has become an integral part of the breast cancer surgical treatment. OPS blends the principals of good local oncological control with plastic surgery techniques for immediate breast reshaping to provide best cosmetic results as well as oncological safety. It helps in extending the boundaries of breast-conservation treatment to include a group of patients who would otherwise require mastectomy to achieve complete excision of the tumour. OPS is a broad concept that can be used for several different combinations of oncological breast-conserving surgery and reconstructive surgery in the form of breast re-shaping/re-modelling. Careful patient selection and pre-operative planning are key components for the success of any OPS operation for breast cancer. Thorough surgical planning is mandatory including clinical assessment and breast measurements with reference to tumour/breast volume ratios. Mastectomy and total breast reconstruction are an option for patients that cannot have breast conservation. In this article, we provide a pictorial review of various oncoplastic and reconstructive breast operations, explaining the indications, essential principles, concepts and techniques of various surgical procedures.Key words: Breast cancer, oncoplastic surgery, breast reconstruction


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