Immediate lipofilling in breast conserving surgery

Abstract

BackgroundThe aim of breast conserving surgery (BCS) is to excise the cancer with clear margins whilst at the same time leaving a good or excellent cosmetic result. A significant percentage of women, who have large cancers or have limited breast volumes, achieve poor cosmetic outcomes. BCS with immediate volume replacement using lipofilling or autologous fat transfer is a new technique. The aim of this study was to evaluate the cosmetic outcomes of a pilot study of patients having BCS and immediate lipofilling performed in The Edinburgh Breast Unit. MethodsQuestionnaires were mailed to 35 women who had BCS with immediate lipofilling and completed by 32 and results compared with those from a contemporary series of 39 women who had BCS alone. The cancers were significantly larger in the lipofilling group (median 21 mm vs. 16 mm p = 0.011) and the patients were non-significantly younger (median age 49 years vs. 54 p = 0.06). ResultsAt a median follow-up of 36 months, results from the Breast Q™ questionnaire showed significantly better cosmetic outcomes with lipofilling (most p < 0.001) and less local breast symptoms (p = 0.0045). There have been no local recurrences in either group and only 1 of the 35 patients was recalled following post-operative surveillance annual mammography. ConclusionBCS and immediate lipofilling provides superior cosmetic outcomes to standard BCS.