Abstract
Lipofilling (LF) is a largely employed technique in reconstructive and esthetic breast surgery. Over the years, it has demonstrated to be extremely useful for treatment of soft tissue defects after demolitive or conservative breast cancer surgery and different procedures have been developed to improve the survival of transplanted fat graft. The regenerative potential of LF is attributed to the multipotent stem cells found in large quantity in adipose tissue. However, a growing body of pre-clinical evidence shows that adipocytes and adipose-derived stromal cells may have pro-tumorigenic potential. Despite no clear indication from clinical studies has demonstrated an increased risk of cancer recurrence upon LF, these observations challenge the oncologic safety of the procedure. This review aims to provide an updated overview of both the clinical and the pre-clinical indications to the suitability and safety of LF in breast oncological surgery. Cellular and molecular players in the crosstalk between adipose tissue and cancer are described, and heterogeneous contradictory results are discussed, highlighting that important issues still remain to be solved to get a clear understanding of LF safety in breast cancer patients.
Highlights
Lipofilling (LF), named autologous fat transplantation (AFT) or fat grafting (FG), is a reconstructive and esthetic technique that is increasingly being used in the field of breast reconstructive surgery [1]
This review aims to provide an integrated overview of both the clinical and the pre-clinical approaches to the suitability of LF after breast surgery in oncological patients, pointing out the several questions still unsolved and the aspects that mainly should be investigated to step toward a clear understanding of risks vs. safety of LF for breast oncological application
Centrifuged lipoaspirate is separated into three phases: tion coming from disrupted adipocytes, watery fraction, which consists of blood, lidocaine, and coming from disrupted adipocytes, watery fraction, which consists of blood, lidocaine, and saline injected before the liposuction, and the purified fat between the oily and watery fractions
Summary
Lipofilling (LF), named autologous fat transplantation (AFT) or fat grafting (FG), is a reconstructive and esthetic technique that is increasingly being used in the field of breast reconstructive surgery [1]. It is widely used to promote an improved reconstruction of the breast after mastectomy or breast-conserving surgery (BCS). Important questions have arisen about the risk of breast cancer (BC) relapse for patients undergoing a LF in the area of the previous BC treatment, especially after conservative treatment, leading to a skeptical or cautious approach by many surgeons to this technique [2,3,4]. This review aims to provide an integrated overview of both the clinical and the pre-clinical approaches to the suitability of LF after breast surgery in oncological patients, pointing out the several questions still unsolved and the aspects that mainly should be investigated to step toward a clear understanding of risks vs safety of LF for breast oncological application
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