Lipofilling poses no added risk for breast cancer recurrence
MedWire News: Reconstructive lipofilling for breast cancer survivors poses no additional risk for local disease recurrence relative to no reconstruction, study results show.
"According to these preliminary results, lipofilling seems to be a safe procedure in breast cancer patients," say study researcher Jean Petit (European Institute of Oncology, Milan, Italy) and colleagues, adding: "Longer follow-up and other experiences from oncological series are urgently required to confirm these findings."
Lipofilling is a reconstructive technique for patients who have undergone surgery to remove a breast tumor - through mastectomy or lumpectomy. It involves taking fat tissue from another part of the body, usually the abdomen, centrifuging it to enrich adipocyte cells, and injecting it in the area where a filling is necessary.
Because of its relative simplicity and good cosmetic results it has proved popular among surgeons and patients. However, some clinicians have raised the possibility that fat cells could stimulate the recurrence of dormant cancer cells through the so-called "tumor-stroma interaction" model.
Indeed, experimental studies have found that adipocyte, pre-adipocyte, and progenitor cell secretions can stimulate angiogenesis and cell growth.
"However, there is lack of translational research that proves this concern in clinical aspect," Petit et al comment in the Annals of Oncology.
For the current study, the researchers collected data on 321 consecutive patients who underwent surgery for primary breast cancer between 1997 and 2008 and subsequently opted for lipofilling for reconstructive purposes. For each patient, they selected two matched patients with similar characteristics who did not undergo lipofilling.
After a median follow-up of 56 months from primary surgery, eight (2.49%) patients in the lipofilling group and 19 (2.96%) in the control group had a local recurrence event - reflecting a nonsignificant difference.
Limiting the analysis to the patients whose primary tumor was a (non-invasive) intraepithelial neoplasia (IN), the lipofilling group had a higher risk for local events (four events) compared with the control group (no events).
Although the difference was significant, Petit et al say this was mostly likely a sampling error among controls, since reported rates of locoregional recurrence after IN are around 1.5% per year and should correspond to a median rate of >2% in the current series after 26-month median follow-up - which clearly was not the case.
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By Andrew Czyzewski