Department of Gynaecology, Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, 2 boulevard Tonnellé, 37044 Tours, France; François-Rabelais University, Tours, France.
Department of Gynaecology, Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, 2 boulevard Tonnellé, 37044 Tours, France; François-Rabelais University, Tours, France; INSERM unit 1069, Tours, France.
J Gynecol Obstet Hum Reprod. 2022 Jan;51(1):102257. doi: 10.1016/j.jogoh.2021.102257. Epub 2021 Oct 22.
The use of autologous fat grafting in the context of breast reconstruction is still a matter of controversy. The objective of this study was to compare the local relapse rate in women who had a fat grafting session in the context of breast reconstruction after breast cancer management, to those who had breast reconstruction without fat grafting.
We performed a retrospective, monocentric, case-control study from January 2007 to December 2017 in our hospital. The cases included women who underwent breast reconstruction with autologous fat grafting and controls, undergoing breast reconstruction without fat grafting. We compared survival and local recurrence between the two groups.
412 women were included: 109 (26.5%) in the lipofilling group and 303 women (73.5%) in the "no lipofilling" group. In the overall study population, lipofilling did not appear to be a predictive factor for recurrence, HR = 1.39 [0.63 - 3.06], p = 0.41; or a predictive factor for overall survival, HR = 0.84 [0.23 - 3.02], p = 0.79, or for distant metastases, HR = 1.10 [0.43 - 2.79], p = 0.84. In contrast, in the subgroup of women treated for invasive cancer, the multivariate analysis showed that lipofilling in this context was an independent predictive factor for local recurrence (HR= 5.06 [1.97 - 10.6], p = 0.04).
we found an increased risk of local recurrence after lipofilling in women who were managed for invasive breast cancer. This suggests that special consideration should be given to women who have had invasive breast cancer before lipofilling.
自体脂肪移植在乳房重建中的应用仍存在争议。本研究的目的是比较乳腺癌管理后行乳房重建时行脂肪移植术与未行脂肪移植术的患者局部复发率。
我们进行了一项回顾性、单中心、病例对照研究,时间为 2007 年 1 月至 2017 年 12 月,在我院进行。病例组包括接受自体脂肪移植乳房重建的女性,对照组包括未接受脂肪移植的乳房重建患者。我们比较了两组患者的生存和局部复发情况。
共纳入 412 例女性:109 例(26.5%)接受脂肪填充组,303 例(73.5%)接受“无脂肪填充”组。在总体研究人群中,脂肪填充似乎不是复发的预测因素,HR=1.39[0.63-3.06],p=0.41;也不是总生存的预测因素,HR=0.84[0.23-3.02],p=0.79,或远处转移的预测因素,HR=1.10[0.43-2.79],p=0.84。相反,在浸润性乳腺癌治疗的女性亚组中,多变量分析显示,在这种情况下脂肪填充是局部复发的独立预测因素(HR=5.06[1.97-10.6],p=0.04)。
我们发现浸润性乳腺癌女性行脂肪填充后局部复发风险增加。这表明在进行脂肪填充之前,应该特别考虑到有浸润性乳腺癌病史的女性。