Silva-Vergara Claudio, Fontdevila Joan, Descarrega Jordi, Burdio Fernando, Yoon Tai-Sik, Grande Luis
Universitat Autònoma de Barcelona, Department of Surgery, Barcelona, Spain; Plastic and Reconstructive Surgery Service, Hospital Clínic Barcelona, Spain.
Plastic and Reconstructive Surgery Service, Hospital Clínic Barcelona, Spain.
J Plast Reconstr Aesthet Surg. 2016 Apr;69(4):475-81. doi: 10.1016/j.bjps.2015.12.029. Epub 2016 Feb 3.
Lipofilling has become a widely used procedure in breast reconstruction after mastectomy or breast-conserving treatment. The possibility that this technique may increase stimulation of cancer development between the potential tumor bed and the lipoaspirates grafts has been raised regarding its safety. The aim of this study was to identify the oncological risks associated with this procedure in our institution.
Between years 2007 and 2014 we record 195 consecutive patients with fat grafting technique for reconstructive purpose after breast cancer treatment. The loco-regional recurrence (LRR) as first event of relapse was the primary end point of this study.
We performed 319 lipofilling procedures in 132 mastectomy and 63 breast-conserving surgery patients. Invasive carcinoma represents 81.6% of the series. The median follow-up from primary cancer surgery and fat grafting was 74 and 31 months respectively. Median time between oncologic surgery and lipofilling was 36 months. The authors observed a complication rate of 8.2%, most of them liponecrosis and oil cysts (7.2%). Four local, 2 regional and 4 distant recurrences were observed as first event of relapse in 10 patients with invasive ductal carcinoma. The loco-regional recurrence rate was 3.1% (1.08% per year).
Although larger prospective trials are needed, these results support the fact that lipofilling following breast cancer treatment leads to a very low rate of complications and similar to other authors, it does not seem to interfere in patient's oncological prognosis when compared with prior publications.
脂肪填充已成为乳房切除术后或保乳治疗后乳房重建中广泛应用的一种手术方法。关于其安全性,有人提出这种技术可能会增加潜在肿瘤床与脂肪抽吸移植之间癌症发展的刺激因素。本研究的目的是确定在我们机构中与该手术相关的肿瘤学风险。
在2007年至2014年期间,我们记录了195例连续接受脂肪移植技术用于乳腺癌治疗后重建目的的患者。以局部区域复发(LRR)作为复发的首发事件是本研究的主要终点。
我们对132例乳房切除患者和63例保乳手术患者进行了319次脂肪填充手术。浸润性癌占该系列病例的81.6%。从原发性癌症手术和脂肪移植开始的中位随访时间分别为74个月和31个月。肿瘤手术与脂肪填充之间的中位时间为36个月。作者观察到并发症发生率为8.2%,其中大多数是脂肪坏死和油囊肿(7.2%)。在10例浸润性导管癌患者中,观察到4例局部复发、2例区域复发和4例远处复发作为复发的首发事件。局部区域复发率为3.1%(每年1.08%)。
尽管需要更大规模的前瞻性试验,但这些结果支持了这样一个事实,即乳腺癌治疗后进行脂肪填充导致的并发症发生率非常低,并且与其他作者的研究结果相似,与先前的出版物相比,它似乎不会干扰患者的肿瘤学预后。