Imaging changes after breast reconstruction with fat grafting - Retrospective study of 90 breast cancer.

Lubna Noor,Helen Rosemary Reeves,Dileep Kumar,Pudhupalayam Bhaskar,Ous Alozairi

doi:10.12669/pjms.321.9460

Lubna Noor, Helen Rosemary Reeves + Show 3 more

Open Access

https://doi.org/10.12669/pjms.321.9460

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Abstract

Objective:To evaluate the breast imaging changes after fat grafting and its impact on cancer follow up.Methods:This is a retrospective observational study conducted on patients who underwent fat grafting for breast reconstruction. We reviewed mammographic and ultrasound images of patients. Fisher’s exact test was used to analyze results. The level of significance was set at P < 0.05.Results:A total of ninety patients with breast cancer had fat grafting. Fifty eight patients for defects following post mastectomy reconstruction and 32 for wide local excision defects. The mean follow up was 37.4 months. Benign lumps were identified in 23/90 cases (25 percent). Mammograms were reported as BI-RADS I in 21/32 cases (72 percent) and BI-RADS II in 8/32 cases (28 percent). BI-RADs III score was reported in two patients on further follow up imaging, both were re-classified as BI-RADS II after biopsy. A total of eight patients (8.9 percent) required biopsy. No local recurrences or new cancers were observed in any patients.Conclusion:Our study suggests radiological changes after fat grafting are almost always benign with no adverse outcome on cancer follow up.

Highlights

Advances in reconstructive breast surgery has improved outcome in breast reconstructions as well as raised the patient’s expectations in restoring breast symmetry
Other concern is that local growth factors and adipose derived regenerative cells (ADRC’s) in grafted fat can induce new cancer growth or predispose to a higher risk of cancer recurrence.[4,5,6]
A total of 90 Fat grafting (FG) procedures were performed for secondary breast reconstruction following cancer surgery during this period

Summary

Introduction

Advances in reconstructive breast surgery has improved outcome in breast reconstructions as well as raised the patient’s expectations in restoring breast symmetry. Fat grafting (FG) is a useful adjunct in breast reconstruction to correct defects after wide local excision (WLE) and post mastectomy reconstructions (PMR) patients. Fat grafting is a fairly simple procedure but there are few concerns. Grafted fat can cause changes in breast tissue with difficulty in interpretation of imaging and interference with cancer diagnosis.[1,2,3] Other concern is that local growth factors and adipose derived regenerative cells (ADRC’s) in grafted fat can induce new cancer growth or predispose to a higher risk of cancer recurrence.[4,5,6]. The purpose of this study was to evaluate imaging changes following fat grafting for breast reconstruction its impact on cancer follow-up

Methods

Results

Conclusion