Huang Zuyan, Li Bo, Long Chenmeng, Wei Guiyi, Zhu Liujing
Department of Breast and Thyroid Surgery, Liuzhou Maternity and Child Healthcare Hospital, Liuzhou, China.
Department of Breast and Thyroid Surgery, Guangzhou Women and Children's Medical Centre Liuzhou Hospital, Liuzhou, China.
Gland Surg. 2025 Aug 31;14(8):1433-1443. doi: 10.21037/gs-2025-109. Epub 2025 Aug 26.
Breast cancer treatment has evolved to focus on not only eradicating the disease but also enhancing the quality of life (QoL) for patients. Free dermal fat graft (FDFG) is used for immediate breast reconstruction (IBR), an emerging technique with the potential for enhanced aesthetic outcomes and improved patient satisfaction. However, concerns remain regarding complications and oncological safety. This study aims to assess the clinical effect, aesthetic outcomes, and oncological safety of FDFG compared to traditional breast-conserving surgery (TBCS) in patients with early-stage breast cancer.
In this retrospective study, data from a total of 106 breast cancer patients were collected with 52 in the FDFG group and 54 in the TBCS group. Follow-up evaluations occurred at six months, one and three years after the surgery, encompassing physical examinations, imaging studies, and tumor markers for monitoring the recurrence or metastasis. The cosmetic outcomes were based on the Breast Cancer Patient-Reported Outcomes Questionnaire (BREAST-Q).
Despite longer operation time, more severe intraoperative bleeding, and greater postoperative drainage volumes in the FDFG group, the complication rates did not differ significantly between the groups. FDFG patients reported significantly higher scores in satisfaction with the breasts and psychosocial well-being in the BREAST-Q survey. There were no significant differences in survival rates, local recurrence rates, regional recurrence rates, or distant metastasis rates. Serum tumor markers decreased postoperatively, with no significant difference observed between the two groups.
In this retrospective study, the short-term cosmetic outcome of FDFG was superior to that of TBCS, and patient satisfaction was higher. There was no significant difference in survival, local recurrence, nor distant metastasis. Nevertheless, further prospective studies are necessary to validate these findings regarding oncological safety.
乳腺癌治疗已发展到不仅注重根除疾病，还关注提高患者的生活质量（QoL）。游离真皮脂肪移植（FDFG）用于即刻乳房重建（IBR），这是一种新兴技术，具有改善美学效果和提高患者满意度的潜力。然而，对于并发症和肿瘤学安全性仍存在担忧。本研究旨在评估早期乳腺癌患者中，FDFG与传统保乳手术（TBCS）相比的临床效果、美学效果和肿瘤学安全性。
在这项回顾性研究中，共收集了106例乳腺癌患者的数据，其中FDFG组52例，TBCS组54例。术后6个月、1年和3年进行随访评估，包括体格检查、影像学检查和肿瘤标志物，以监测复发或转移情况。美容效果基于乳腺癌患者报告结局问卷（BREAST-Q）。
尽管FDFG组手术时间更长、术中出血更严重、术后引流量更大，但两组并发症发生率无显著差异。FDFG组患者在BREAST-Q调查中对乳房的满意度和心理社会幸福感得分显著更高。生存率、局部复发率、区域复发率或远处转移率无显著差异。术后血清肿瘤标志物下降，两组间无显著差异。
在这项回顾性研究中，FDFG的短期美容效果优于TBCS，患者满意度更高。在生存、局部复发或远处转移方面无显著差异。然而，需要进一步的前瞻性研究来验证这些关于肿瘤学安全性的发现。
