Page 20 - Delaware Medical Journal - January 2016

State of the Art: Reconstructing Partial Mastectomy Defects with Autologous Fat Grafting
Erik Hoy, MD, MBA
Abstract: It is estimated that more than 231,840 new cases of invasive breast cancers will be diagnosed in 2015. Many of these patients will be treated with lumpectomy and radiation or with mastectomy. Historically less than 25 percent of patients undergo immediate breast reconstruction, and autologous fat grafting represents a technique to help address some of the difficulties encountered in delayed reconstruction. The use of autologous fat grafting for reconstruction of soft-tissue defects is an increasingly common practice. Despite early concerns regarding the safety of autologous fat into the breasts, recent studies have shown this to be both safe and effective. This study examines the use of autologous fat to replace and reconstruct the tissues removed in a left lower pole partial mastectomy for cancer in a patient treated with radiation. This represents a minimally-invasive, staged approach to the correction of a difficult problem.
Key Words: Fat grafting, autologous tissue, breast reconstruction, mastectomy, lumpectomy, radiation.
IntroductionThere are more than
2.8 million breast cancer
survivors in the United States, and in 2015 it is estimated that more than 231,840 new cases of invasive breast cancer will
be diagnosed, along with 60,290 cases of carcinoma in-situ.1 Mastectomy rates are increasing, and approximately 35-40 percent of women of newly diagnosed women undergo mastectomy.2 Despite documented improvements in quality-of-life, body
image, sexuality, and self-esteem associated with immediate reconstruction, fewer than 25 percent of women choose this route.3
Delayed reconstruction following breast-conserving surgery (lumpectomy or partial mastectomy) or after total unpredictable vascular supply, and contour deformities.4 Conversely, delayed reconstruction with an implant may be associated with lower rates of capsular contracture5, but is not an option for many patients. Postmastectomy radiation is also associated with higher complication rates following reconstruction, and is increasingly being used in the U.S. to decrease the risk of breast cancer recurrence.6
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Del Med J | January 2016 | Vol. 88 | No. 1
Abstract