Lyon, France From the Department of Plastic and Reconstructive Surgery, University of Lyon-Léon Bérard Cancer Center; the Unit of Radiology, Jean Mermoz Private Hospital; private practice; and the Department of Plastic Surgery, Edouard Herriot Hospital, University of Lyon.
Plast Reconstr Surg. 2011 Mar;127(3):1289-1299. doi: 10.1097/PRS.0b013e318205f38f.
Fat transfer to healthy breasts, that is, in women with no history of breast disease, particularly breast cancer, is becoming increasingly popular. The main issue remains whether the transfer of fat cells to the native breast hampers breast imaging. This pilot study aimed to assess the effectiveness of radiographic evaluation after breast lipomodeling and to propose objective elements for the detection of mammographic signs, and for postoperative evaluation of breast density and Breast Imaging Reporting and Data System (American College of Radiology) classification.
The authors retrospectively reviewed the radiographic findings of patients undergoing breast lipomodeling between 2000 and 2008. A descriptive semiologic analysis was conducted. Then, the authors compared breast tissue density and Breast Imaging Reporting and Data System categorization in 20 patients with preoperative and postoperative images available for review.
The descriptive analysis identified 16 percent of mammograms with microcalcifications, 9 percent with macrocalcifications, 25 percent with clear well-focused images of cystic lesions, and 12 percent with tissue remodeling. The comparative study showed no statistically significant difference between breast density findings before and after fat injection, whether using the American College of Radiology classification or a personalized rating system. Similarly, no significant difference was observed using the American College of Radiology Breast Imaging Reporting and Data System categorization before and after fat grafting.
Radiographic follow-up of breasts treated with fat grafting is not problematic and should not be a hindrance to the procedure. However, the authors' preliminary results should be confirmed in larger series, and the radiographic follow-up of women undergoing breast lipomodeling should be standardized to ensure reproducibility and improve patient safety.
向健康乳房(即无乳腺疾病史,尤其是乳腺癌史的女性)转移脂肪的做法正变得越来越流行。主要问题仍然是脂肪细胞向原生乳房的转移是否会妨碍乳房成像。本研究旨在评估乳房脂肪成型术后的放射学评估效果,并提出用于检测乳房摄影征象、术后乳房密度和乳腺影像报告与数据系统(美国放射学院)分类的客观要素。
作者回顾性分析了 2000 年至 2008 年间接受乳房脂肪成型术的患者的放射学发现。进行了描述性半定量分析。然后,作者比较了 20 例术前和术后可用于评估的乳房组织密度和乳腺影像报告与数据系统分类。
描述性分析发现 16%的乳房 X 光片有微钙化,9%有大钙化,25%有清晰聚焦的囊性病变图像,12%有组织重塑。比较研究显示,脂肪注射前后,使用美国放射学院分类或个性化评分系统,乳房密度均无统计学差异。同样,在使用美国放射学院乳腺成像报告和数据系统分类前后,也未观察到脂肪移植前后的显著差异。
脂肪移植治疗后的乳房进行放射学随访并不成问题,不应成为该手术的阻碍。然而,作者的初步结果应在更大的系列中得到证实,并且应标准化接受乳房脂肪成型术的女性的放射学随访,以确保可重复性并提高患者安全性。