Brenelli Fabricio, Rietjens Mario, De Lorenzi Francesca, Pinto-Neto Aarão, Rossetto Fabio, Martella Stefano, Rodrigues José R P, Barbalho Daniel
Department of Gyanecology and Obstetrics - Breast Oncology Division, State University of Campinas (Unicamp), Campinas - São Paulo, Brazil; Division of Breast Surgery, São José's Hospital, Beneficencia Portuguesa de São Paulo, São Paulo, Brazil.
Breast J. 2014 Mar-Apr;20(2):159-65. doi: 10.1111/tbj.12225. Epub 2014 Jan 23.
Autologous fat graft to the breast is a useful tool to correct defects after breast conservative treatment (BCT). Although this procedure gains popularity, little is known about the interaction between the fat graft and the prior oncological environment. Evidences of safety of this procedure in healthy breast and after post-mastectomy reconstruction exist. However, there is paucity of data among patients who underwent BCT which are hypothetically under a higher risk of local recurrence (LR). Fifty-nine patients, with prior BCT, underwent 75 autologous fat graft procedures using the Coleman's technique, between October 2005 and July 2008. Follow-up was made by clinical and radiologic examination at least once, after 6 months of the procedure. Mean age was 50 ± 8.5 years, and mean follow-up was 34.4 ± 15.3 months. Mean time from oncological surgery to the first fat grafting procedure was 76.6 ± 30.9 months. Most of patients were at initial stage 0 (11.8%), I (33.8%), or IIA (23.7%). Immediate complication was observed in three cases (4%). Only three cases of true LR (4%) associated with the procedure were observed during the follow-up. Abnormal breast images were present in 20% of the postoperative mammograms, and in 8% of the cases, biopsy was warranted. Autologous fat graft is a safe procedure to correct breast defects after BCT, with low postoperative complications. Although it was not associated with increased risk of LR in the group of patients studied, prospective trials are needed to certify that it does not interfere in patient's oncological prognosis.
自体脂肪移植到乳房是一种用于纠正保乳治疗（BCT）后缺陷的有用方法。尽管该手术越来越受欢迎，但对于脂肪移植与先前肿瘤学环境之间的相互作用知之甚少。该手术在健康乳房以及乳房切除术后重建中的安全性已有证据。然而，在假设局部复发（LR）风险较高的接受BCT的患者中，数据却很匮乏。2005年10月至2008年7月期间，59例曾接受过BCT的患者采用科尔曼技术进行了75次自体脂肪移植手术。术后6个月后，至少进行一次临床和影像学检查以进行随访。平均年龄为50±8.5岁，平均随访时间为34.4±15.3个月。从肿瘤手术到首次脂肪移植手术的平均时间为76.6±30.9个月。大多数患者处于初始0期（11.8%）、I期（33.8%）或IIA期（23.7%）。3例（4%）观察到即刻并发症。随访期间仅观察到3例与该手术相关的真正LR（4%）。术后乳房X线照片中20%出现乳房图像异常，其中8%的病例需要进行活检。自体脂肪移植是一种纠正BCT后乳房缺陷的安全手术，术后并发症发生率低。尽管在所研究的患者组中它与LR风险增加无关，但仍需要进行前瞻性试验以证实它不会干扰患者的肿瘤学预后。
