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25-03-2012 | Surgery | Article

Reconstructive technique effective for women with partial mastectomy defects

Abstract

Free abstract

MedWire News: Adipose-derived regenerative cell (ADRC)-enriched fat grating is an effective reconstructive option for women with partial mastectomy defects, show results of the RESTORE-2 trial.

"RESTORE [Regenerative Cells Transplanted to Reconstruct Breast Deformities After Lumpectomy]-2 demonstrated substantial improvement in breast defects after one or two treatments and the results were stable through 12 months," write the authors in the European Journal of Surgical Oncology.

Following cancer treatment, patients' breast tissue can suffer from radiation injury, scarring, and tight skin, explained lead author of the study Eva Weiler-Mithoff (Glasgow Royal Infirmary, Scotland, UK) in a press statement.

"This new technique is exciting because it may offer the opportunity to resolve some of the most difficult to treat conditions where other approaches, including fat alone, do not achieve satisfactory results," she said.

The investigators enrolled 71 female patients who had undergone breast conservation therapy (BCT) and presented with partial mastectomy defects up to 150 mL. Of these, 67 completed the follow up.

The ADRC-enriched fat grafting procedure involved collection of adipose tissue via syringe lipoharvest. The tissue was then processed using a closed automated system that isolates ADRCs and prepares an ADRC-enriched fat graft for immediate re-implantation. Next, the investigators performed ADRC-enriched fat graft injections in a fan-shaped pattern to prevent pooling of the injected fat.

Overall procedure times were less than 4 hours. Twenty-four patients elected to undergo a second procedure following the 6-month follow-up visit.

The researchers report high rates of investigator (85%) and patient (75%) satisfaction with the overall treatment results at 12 months. High rates of investigator (87%) and patient (67%) satisfaction were also seen for overall breast deformity (based on functional and cosmetic outcomes) at 12 months.

Magnetic resonance imaging assessment demonstrated an "improved" or "much improved" breast contour at 6 and 12 months compared with baseline in 51 out of 66 patients and 54 out of 65 patients, respectively.

There were no local cancer recurrences or serious adverse events related to the ADRC-enriched fat graft injection procedure.

"This prospective trial demonstrates the safety and efficacy of the treatment of BCT defects utilizing ADRC-enriched fat grafts," say Weiler-Mithoff et al. "Thus, this procedure should be considered as an alternative reconstructive option for women with post-BCT defects."

They conclude: "Future comparative studies are needed to determine the incremental benefit of ADRC-enriched fat grafting as compared to traditional fat grafting in various clinical circumstances."

By Nikki Withers

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