Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
5-Year IF – 2.0, IF – 1.9, JCI (2024) – 0.43
Scopus CiteScore – 4.3
Q1 in SJR 2024, SJR score – 0.598, H-index: 49 (SJR)
ICV – 161.00; MNiSW – 70 pts
Initial editorial assessment and first decision within 24 h

ISSN 1899–5276 (print), ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2018, vol. 27, nr 6, June, p. 773–780

doi: 10.17219/acem/68977

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Surgical and oncological outcomes of free dermal fat graft for breast reconstruction after breast-conserving surgery

Fabrizio De Biasio1,A,B,C,D,E,F, Serena Bertozzi2,A,B,C,D,E,F, Ambrogio P. Londero3,A,B,C,D,E,F, Daria Almesberger1,A,B,C,D,E,F, Chiara Zanin1,A,B,C,D,E,F, Andrea Marchesi4,D,E,F, Carla Cedolini2,A,B,C,D,E,F, Andrea Risaliti2,D,E,F, Pier C. Parodi1,A,B,C,D,E,F

1 Clinic of Plastic and Reconstructive Surgery, Department of Medical Area, University of Udine, Italy

2 Clinic of Surgery, Department of Medical Area, University of Udine, Italy

3 Clinic of Obstetrics and Gynecology, University of Udine, Italy

4 Department of Plastic and Reconstructive Surgery, IRCCS Policlinico San Donato, University of Milan, Italy

Abstract

Background. Oncoplastic breast surgery originated in order to improve the esthetic result of breast-conserving surgery (BCS). Autologous free dermal fat graft (FDFG) is an emerging oncoplastic technique to improve the cosmetic outcome of breast-conserving surgery.
Objectives. The aim of this study was to analyze our experience with FDFGs in breast reconstruction after breast-conserving surgery. Oncological outcomes, surgical complications and cosmetic results were considered.
Material and Methods. This retrospective chart review study considered all consecutive oncoplastic breast treatment by means of FDFG reconstruction during the period between September 2011 and September 2012 in our Clinic of Surgery (University of Udine, Italy). The data collected included patient and tumor characteristics and outcomes (cosmetic and oncological).
Results. During the study period, 37 women were treated by breast cancer surgery and immediate breast reconstruction by FDFG. At a 3-year follow-up, we found no cases of recurrence among breast cancer patients treated by FDFG; at a 18-month follow-up, we found a prevalence of 75.0% of women extremely satisfied with their oncoplastic surgery and a high prevalence of excellent or good cosmetic outcomes (70.3%) according to objective and subjective cosmetic assessment.
Conclusion. Immediate breast reconstruction by FDFG after BCS in a population selected for a low risk of breast cancer recurrence seems to be an oncologically safe option, with a good cosmetic outcome and a high prevalence of women satisfied with the treatment.

Key words

breast cancer, disease free survival, free dermal fat graft, oncoplastic surgery, breast-conserving surgery

References (19)

  1. Driul L, Bernardi S, Bertozzi S, Schiavon M, Londero AP, Petri R. New surgical trends in breast cancer treatment: Conservative interventions and oncoplastic breast surgery. Minerva Ginecol. 2013;65:289–296.
  2. Urban C, Lima R, Schunemann E, Spautz C, Rabinovich I, Anselmi K. Oncoplastic principles in breast conserving surgery. Breast. 2011; 20(Suppl 3):92–95.
  3. Blondeel PN, Hijjawi J, Depypere H, Roche N, Van Landuyt K. Shaping the breast in aesthetic and reconstructive breast surgery: An easy three-step principle. Part III – Reconstruction following breast conservative treatment. Plast Reconstr Surg. 2009;124:28–38.
  4. Haloua MH, Krekel NMA, Winters HAH, et al. A systematic review of oncoplastic breast-conserving surgery: Current weaknesses and future prospects. Ann Surg. 2013;257:609–620.
  5. Kijima Y, Yoshinaka H, Funasako Y, et al. Immediate breast reconstruction using autologous free dermal fat grafts provides better cosmetic results for patients with upper inner cancerous lesions. Surg Today. 2011;41:477–489.
  6. Kijima Y, Yoshinaka H, Owaki T, Aikou T. Early experience of immediate reconstruction using autologous free dermal fat graft after breast conservational surgery. J Plast Reconstr Aesthet Surg. 2007;60:495–502.
  7. Del Frate C, Borghese L, Cedolini C, et al. Role of pre-surgical breast MRI in the management of invasive breast carcinoma. Breast. 2007;16: 469–481.
  8. Cedolini C, Bertozzi S, Seriau L, et al. Eight-year experience with the intraoperative frozen section examination of sentinel lymph node biopsy for breast cancer in a North-Italian university center. Int J Clin Exp Pathol. 2014;7:364–371.
  9. Vrieling C, Collette L, Fourquet A, et al.; EORTC Radiotherapy and Breast Cancer Cooperative Groups. The influence of patient, tumor and treatment factors on the cosmetic results after breast-conserving therapy in the EORTC ’boost vs no boost’ trial. Radiother Oncol. 2000;55:219–232.
  10. Ozaki S, Ohara M, Shigematsu H, et al. Technical feasibility and cosmetic advantage of hybrid endoscopy-assisted breast-conserving surgery for breast cancer patients. J Laparoendosc Adv Surg Tech A. 2013;23:91–99.
  11. Cedolini C, Bertozzi S, Londero AP, et al. Type of breast cancer diagnosis, screening, and survival. Clin Breast Cancer. 2014;14:235–240.
  12. Cedolini C, Bertozzi S, Seriau L, et al. Feasibility of conservative breast surgery and intraoperative radiation therapy for early breast cancer: A single-center, open, non-randomized, prospective pilot study. Oncol Rep. 2014;31:1539–1546.
  13. Arnone P, Zurrida S, Viale G, et al. The TNM classification of breast cancer: Need for change. Updates Surg. 2010;62:75–81.
  14. Clough KB, Lewis JS, Couturaud B, Fitoussi A, Nos C, Falcou MC. Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas. Ann Surg. 2003;237:26–34.
  15. Biazus JV, Falcão CC, Parizotto AC, et al. Immediate reconstruction with autologous fat transfer following breast-conserving surgery. Breast J. 2015; 21(3):268–275.
  16. Bernardi S, Bertozzi S, Londero AP, et al. Nine years of experience with the sentinel lymph node biopsy in a single Italian center: A retrospective analysis of 1,050 cases. World J Surg. 2012;36:714–722.
  17. 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;128:341–346.
  18. Semprini G, Cattin F, Lazzaro L, Cedolini C, Parodi PC. About locoregional recurrence risk after lipofilling in breast cancer patients. Ann Oncol. 2012;23:802–804.
  19. Semprini G, Cattin F, Zanin C, et al. About locoregional recurrence risk after lipofilling in breast cancer patients: Our experience. Minerva Chir. 2014;69:91–96.
© Wroclaw Medical University