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Oncologic Safety of Autologous Fat Grafting in Reconstructive Breast Surgery
Summer E. Hanson, MD, PhD, Patrick B. Garvey, MD, Jun Liu, MD, PhD, Charles E. Butler, MD.
The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Background: Autologous fat grafting (AFG) is used in breast reconstruction to address contour deformity and improve radiation fibrosis. The purpose of this study was to review our experience with fat grafting in breast reconstruction with a focus on oncologic safety.
Methods: We retrospectively reviewed our central database for patients who underwent AFG to the breast following mastectomy or breast conservation therapy (BCT) between 2001 and 2014 as well as matched patients with breast cancer who did not have AFG. The primary outcome of interest was local regional recurrence (LRR).
Results: We found 719 patients who underwent AFG following breast cancer treatment versus 670 controls who did not have AFG. Average follow up was 52 months. The majority of patients had mastectomy (640/719 AFG versus 597/670 controls). Overall, we found no difference in LRR rate between patients with AFG (1.3%) versus controls (2.4%; p=0.45). Autologous fat grafting did not affect the risk of LRR in subgroups including pathological stage, mastectomy type, hormone receptor status, or chemotherapy/radiation therapy. However, AFG patients treated with adjuvant hormonal therapy showed a slightly higher rate of LRR (1.4% versus 0.5%; p=0.38). We found no difference in systemic recurrence rate (2.4% versus 3.6%; p=0.51).
Conclusions: This represents the largest single institution study that looks at the safety of AFG in breast cancer reconstruction. We demonstrate no significant difference in LRR or systemic recurrence between fat grafted cases and controls. Overall, we believe these data support the oncologic safety of autologous fat grafting in breast reconstruction surgery.


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