Top

Annals of Surgical Oncology

Published in:

01-01-2013 | Breast Oncology

Oncological Safety of Autologous Lipoaspirate Grafting in Breast Cancer Patients: A Systematic Review

Authors: T. K. Krastev, MD, Y. Jonasse, MD, M. Kon, MD, PhD

Published in: Annals of Surgical Oncology | Issue 1/2013

Abstract

Background

Autologous lipoaspirate grafting (ALAG) has become a widely used treatment in breast reconstruction after mastectomy (MST) or breast-conserving treatment (BCT), although there is an ongoing debate about its oncological safety. The aim of this systematic review was to identify, evaluate, and synthesize all clinical evidence examining the oncological risks associated with the procedure.

Methods

An extensive electronic search was performed in PubMed, Embase, and the Cochrane Library using the keywords “breast” and “autologous lipoaspirate grafting” and synonyms.

Results

The search yielded a total of 269 unique hits. Twenty clinical trials investigated ALAG in breast reconstruction after cancer. Although nine of them provided oncological follow-up data, only one retrospective cohort and four case series were suitable for analysis. The former reported no significant differences in the locoregional recurrence (LRR) incidence rates between the intervention and control groups for patients with MST as well as BCT. A large multicenter case series reported LRR incidence rates of 1.35 and 2.19 for MST and BCT patients, respectively. The remaining two series were far smaller trials with shorter follow-up and reported no recurrences. No randomized, controlled trials were identified. Most of the available studies consisted of cohorts and case series with short follow-up and no control subjects.

Conclusions

Although the first reports on cancer recurrence after ALAG are inconclusive, they show promising results. Whether lipoaspirate grafting promotes LRR in breast cancer patients is still unclear. To be able to answer this question, larger prospective trials with longer follow-up are needed.

Available only for authorised users

Bircoll M, Novack BH. Autologous fat transplantation employing liposuction techniques. Ann Plast Surg. 1987;18:327–9.PubMedCrossRef

ASPRS Ad-Hoc Committee on New Procedures. Report on autologous fat transplantation. Ann Plast Surg. 1987;7:140–1.

Coleman SR. Facial recontouring with lipostructure. Ann Plast Surg. 1997;24:347–67.

Elfadl D, Garimella V, Mahapatra TK, et al. Lipomodelling of the breast: a review. Breast. 2010;19:202–9.PubMedCrossRef

Chan CW, McCulley SJ, Macmillan RD. Autologous fat transfer—a review of the literature with a focus on breast cancer surgery. J Plast Reconstr Aesthet Surg. 2008;61:1438–48.PubMedCrossRef

Parrish JN, Metzinger SE. Autogenous fat grafting and breast augmentation: a review of the literature. Aesthet Surg J. 2010;30:549–56.PubMedCrossRef

Coleman SR. Structural fat grafting: more than a permanent filler. Plast Reconstr Surg. 2006;118:108S–20S.PubMedCrossRef

Coleman SR, Saboeiro AP. Fat grafting to the breast revisited: safety and efficacy. Plast Reconstr Surg. 2007;119:775–85.PubMedCrossRef

Zocchi ML, Zuliani F. Bicompartmental breast lipostructuring. Aesthetic Plast Surg. 2008;32:313–28.PubMedCrossRef

10.

Del Vecchio DA, Bucky LP. Breast augmentation using preexpansion and autologous fat transplantation: a clinical radiographic study. Plast Reconstr Surg. 2011;127:2441–50.PubMedCrossRef

11.

Rigotti G, Marchi A, Galie M, et al. Clinical treatment of radiotherapy tissue damage by lipoaspirate transplant: a healing process mediated by adipose-derived adult stem cells. Plast Reconstr Surg. 2007;119:1409–22.PubMedCrossRef

12.

Panettiere P, Marchetti L, Accorsi D. The serial free fat transfer in irradiated prosthetic breast reconstructions. Aesthetic Plast Surg. 2009;33:695–700.PubMedCrossRef

13.

Locke M, Feisst V, Dunbar PR. Concise review: human adipose-derived stem cells: separating promise from clinical need. Stem Cells. 2011;29:404–11.PubMedCrossRef

14.

Suga H, Eto H, Aoi N, et al. Adipose tissue remodeling under ischemia: death of adipocytes and activation of stem/progenitor cells. Plast Reconstr Surg. 2010;126:1911–23.PubMedCrossRef

15.

Martin-Padura I, Gregato G, Marighetti P, et al. The white adipose tissue used in lipotransfer procedures is a rich reservoir of CD34⁺ progenitors able to promote cancer progression. Cancer Res. 2012;72:325–34.PubMedCrossRef

16.

Brown SA, Levi B, Lequeux C, et al. Basic science review on adipose tissue for clinicians. Plast Reconstr Surg. 2010;126:1936–46.PubMedCrossRef

17.

Baer PC. Adipose-derived stem cells and their potential to differentiate into the epithelial lineage. Stem Cells Dev. 2011;20:1805–16.PubMedCrossRef

18.

Karnoub AE, Dash AB, Vo AP, et al. Mesenchymal stem cells within tumour stroma promote breast cancer metastasis. Nature. 2007;449:557–63.PubMedCrossRef

19.

Muehlberg FL, Song YH, Krohn A, et al. Tissue-resident stem cells promote breast cancer growth and metastasis. Carcinogenesis. 2009;30:589–97.PubMedCrossRef

20.

Pinilla S, Alt E, Abdul Khalek FJ, et al. Tissue resident stem cells produce CCL5 under the influence of cancer cells and thereby promote breast cancer cell invasion. Cancer Lett. 2009;284:80–5.PubMedCrossRef

21.

Yu JM, Jun ES, Bae YC, Jung JS. Mesenchymal stem cells derived from human adipose tissues favor tumor cell growth in vivo. Stem Cells Dev. 2008;17:463–73.PubMedCrossRef

22.

Iyengar P, Combs TP, Shah SJ, et al. Adipocyte-secreted factors synergistically promote mammary tumorigenesis through induction of anti-apoptotic transcriptional programs and proto-oncogene stabilization. Oncogene. 2003;22:6408–23.PubMedCrossRef

23.

Manabe Y, Toda S, Miyazaki K, Sugihara H. Mature adipocytes, but not preadipocytes, promote the growth of breast carcinoma cells in collagen gel matrix culture through cancer–stromal cell interactions. J Pathol. 2003;201:221–8.PubMedCrossRef

24.

Vona-Davis L, Rose DP. Adipokines as endocrine, paracrine, and autocrine factors in breast cancer risk and progression. Endocr Relat Cancer. 2007;14:189–206.PubMedCrossRef

25.

Donnenberg VS, Zimmerlin L, Rubin JP, Donnenberg AD. Regenerative therapy after cancer: what are the risks? Tissue Eng Part B Rev. 2010;16:567–75.PubMedCrossRef

26.

Zimmerlin L, Donnenberg AD, Rubin JP, et al. Regenerative therapy and cancer: in vitro and in vivo studies of the interaction between adipose-derived stem cells and breast cancer cells from clinical isolates. Tissue Eng Part A. 2011;17:93–106.PubMedCrossRef

27.

ClinialTrials.gov. Adipose tissue transfer for moderate breast cancer conservative treatment sequella (GRATSEC). NCT01035268.

28.

Gutowski KA, Baker SB, Coleman SR, et al. Current applications and safety of autologous fat grafts: a report of the ASPS Fat Graft Task Force. Plast Reconstr Surg. 2009;124:272–80.PubMedCrossRef

29.

Knobloch K, Yoon U, Vogt PM. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement and publication bias. J Craniomaxillofac Surg. 2011;39:91–2.PubMedCrossRef

30.

Oxford Centre for Evidence-based Medicine. Levels of evidence. http://www.eeplus.mobi/product/ebm_loe.cfm?show=oxford.

31.

Petit JY, Botteri E, Lohsiriwat V, et al. Locoregional recurrence risk after lipofilling in breast cancer patients. Ann Oncol. 2012;23:582–8.PubMedCrossRef

32.

Petit JY, Lohsiriwat V, Clough KB, et al. The oncologic outcome and immediate surgical complications of lipofilling in breast cancer patients: a multicenter study—Milan–Paris–Lyon experience of 646 lipofilling procedures. Plast Reconstr Surg. 2011;128:341–6.PubMedCrossRef

33.

Rietjens M, De Lorenzi F, Rossetto F, et al. Safety of fat grafting in secondary breast reconstruction after cancer. J Plast Reconstr Aesthet Surg. 2011;64:477–83.PubMedCrossRef

34.

Rigotti G, Marchi A, Stringhini P, et al. Determining the oncological risk of autologous lipoaspirate grafting for post-mastectomy breast reconstruction. Aesthetic Plast Surg. 2010;34:475–80.PubMedCrossRef

35.

Missana MC, Laurent I, Barreau L, Balleyguier C. Autologous fat transfer in reconstructive breast surgery: indications, technique and results. Eur J Surg Oncol. 2007;33:685–90.PubMedCrossRef

36.

Delay E, Gosset J, Toussoun G, et al. [Efficacy of lipomodelling for the management of sequelae of breast cancer conservative treatment]. Ann Chir Plast Esthet. 2008;53:153–68.PubMedCrossRef

37.

Sarfati I, Ihrai T, Kaufman G, et al. Adipose-tissue grafting to the post-mastectomy irradiated chest wall: preparing the ground for implant reconstruction. J Plast Reconstr Aesthet Surg. 2011;64:1161–6.PubMedCrossRef

38.

Delaporte T, Delay E, Toussoun G, et al. [Breast volume reconstruction by lipomodeling technique: about 15 consecutive cases]. Ann Chir Plast Esthet. 2009;54:303–16.PubMedCrossRef

39.

Beck M, Amar O, Bodin F, et al. Evaluation of breast lipofilling after sequelae of conservative treatment for cancer—a prospective study of ten cases. Eur J Plast Surg. 2011;1–8.

40.

Illouz YG, Sterodimas A. Autologous fat transplantation to the breast: a personal technique with 25 years of experience. Aesthetic Plast Surg. 2009;33:706–15.PubMedCrossRef

41.

Sinna R, Delay E, Garson S, et al. Breast fat grafting (lipomodelling) after extended latissimus dorsi flap breast reconstruction: a preliminary report of 200 consecutive cases. J Plast Reconstr Aesthet Surg. 2010;63:1769–77.PubMedCrossRef

42.

Kanchwala SK, Glatt BS, Conant EF, Bucky LP. Autologous fat grafting to the reconstructed breast: the management of acquired contour deformities. Plast Reconstr Surg. 2009;124:409–18.PubMedCrossRef

43.

Losken A, Pinell XA, Sikoro K, et al. Autologous fat grafting in secondary breast reconstruction. Ann Plast Surg. 2011;66:518–22.PubMedCrossRef

44.

Serra-Renom JM, Munoz-Olmo JL, Serra-Mestre JM. Fat grafting in postmastectomy breast reconstruction with expanders and prostheses in patients who have received radiotherapy: formation of new subcutaneous tissue. Plast Reconstr Surg. 2010;125:12–8.PubMed

45.

Spear SL, Wilson HB, Lockwood MD. Fat injection to correct contour deformities in the reconstructed breast. Plast Reconstr Surg. 2005;116:1300–5.PubMedCrossRef

46.

Irani Y, Casanova D, Amar E. [Autologous fat grafting in radiated tissue prior to breast prosthetic reconstruction: is the technique reliable?]. Ann Chir Plast Esthet. 2012;57:59–66.PubMedCrossRef

47.

de Blacam C, Momoh AO, Colakoglu S, et al. Evaluation of clinical outcomes and aesthetic results after autologous fat grafting for contour deformities of the reconstructed breast. Plast Reconstr Surg. 2011;128:411e–18e.PubMedCrossRef

48.

Salgarello M, Visconti G, Rusciani A. Breast fat grafting with platelet-rich plasma: a comparative clinical study and current state of the art. Plast Reconstr Surg. 2011;127:2176–85.PubMedCrossRef

49.

Petit JY, Gentilini O, Rotmensz N, et al. Oncological results of immediate breast reconstruction: long term follow-up of a large series at a single institution. Breast Cancer Res Treat. 2008;112:545–9.PubMedCrossRef

50.

Botteri E, Bagnardi V, Rotmensz N, et al. Analysis of local and regional recurrences in breast cancer after conservative surgery. Ann Oncol. 2010;21:723–8.PubMedCrossRef

51.

van Dongen JA, Voogd AC, Fentiman IS, et al. Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy. European Organization for Research and Treatment of Cancer 10801 trial. J Natl Cancer Inst. 2000;92:1143–50.PubMedCrossRef

52.

Delay E, Garson S, Tousson G, Sinna R. Fat injection to the breast: technique, results, and indications based on 880 procedures over 10 years. Aesthet Surg J. 2009;29:360–76.PubMedCrossRef

53.

Rietjens M, Urban CA, Rey PC, et al. Long-term oncological results of breast conservative treatment with oncoplastic surgery. Breast. 2007;16:387–95.PubMedCrossRef

Title: Oncological Safety of Autologous Lipoaspirate Grafting in Breast Cancer Patients: A Systematic Review
Authors: T. K. Krastev, MD
Y. Jonasse, MD
M. Kon, MD, PhD
Publication date: 01-01-2013
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 1/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-012-2565-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Oncological Safety of Autologous Lipoaspirate Grafting in Breast Cancer Patients: A Systematic Review

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2013

Comparison of the Sixth and the Seventh Editions of the UICC Classification for Perihilar Cholangiocarcinoma

The Current Role of Surgery in Metastatic Spine Disease: A New Era

Surgical Resection after Downsizing Chemotherapy for Initially Unresectable Locally Advanced Biliary Tract Cancer: A Retrospective Single-center Study

Cost-Effectiveness of Treatment Strategies for Primary Operable Pancreatic Head Adenocarcinoma: Do We Have More Scientific Evidence to Call for Further Centralization of Care?

Prognostic Relevance of Number and Ratio of Metastatic Lymph Nodes in Resected Pancreatic, Ampullary, and Distal Bile Duct Carcinomas

Up-front Hepatic Resection for Metastatic Colorectal Cancer Results in Favorable Long-term Survival