%0 Journal Article
%T Oncologic safety of autologous fat grafting in primary breast reconstruction after mastectomy for cancer.
%A Navarro AS
%A Omalek D
%A Chaltiel L
%A Vaysse C
%A Meresse T
%A Gangloff D
%A Jouve E
%A Selmes G
%J Eur J Surg Oncol
%V 50
%N 4
%D 2024 Apr 15
%M 38460246
%F 4.037
%R 10.1016/j.ejso.2024.107998
%X <B>BACKGROUND: </B>Autologous fat transfer (AFT) is widely used to improve results of breast reconstructive surgery, but its safety is controversial. Our objective was to evaluate the oncologic safety of AFT in a homogeneous population of patients who underwent a total mastectomy with immediate reconstruction for breast cancer.<BR><B>METHODS: </B>We performed a retrospective cohort study by identifying all patients who underwent immediate breast reconstruction after mastectomy for breast cancer from 2007 to 2015 in our center. A patient group with AFT performed in the 24 months after mastectomy was compared to a control group.<BR><B>RESULTS: </B>Five hundred fifty cases were included, of whom 136 (24.7%) underwent at least one fat graft transfer. Median age was 51 years. Reconstruction was performed in 465 (84.5%) with an implant reconstruction. The median time from mastectomy to AFT was 13.8 months. The median follow up was 55.2 months. A total of 53 events were observed, including 10 (7.4%) in the AFT group and 43 (10.4%) in the control group. There was no difference in 5-year recurrence-free survival (RFS) between the groups. In the subgroup analysis, only lymph node involvement in patients who underwent AFT in the first 24 months after oncologic surgery appeared as a risk factor of recurrence. Among the 104 patients with lymph node involvement, 5-year RFS was 69.2% in patients with lipofilling vs 92.5% in patients without it (p = 0 0.0351).<BR><B>CONCLUSIONS: </B>Performing early lipofilling in primary breast reconstruction after mastectomy for cancer seems to be oncologically safe. Lymph node involvement increases the risk of recurrence in this population.