July 29, 2011 -- Fat injections to contour the breasts after breast cancer surgery, known as lipofilling, appear safe, according to a new study.
But the researchers add strong caveats to that conclusion.
"After breast cancer treatment, the patient has to be followed more carefully," says study researcher Jean Yves Petit, MD, of the European Institute of Oncology in Milan, Italy. A surgeon experienced in the technique must do the surgery, he tells WebMD.
The study is published in Plastic and Reconstructive Surgery.
While the complication rate was low, Petit says it is too soon to prove safety in terms of cancer recurrence. "We cannot provide the definitive proof of the safety of lipofilling in terms of cancer recurrence or distant metastasis," he writes. Longer studies are need, he tells WebMD. His follow-up lasted about a year and a half.
In another recent study, Petit compared women who had lipofilling after breast cancer with comparison women who did not have the procedure and found it safe, although he still concludes that more study is needed. That study is published in the Annals of Oncology.
In lipofilling, fat is taken by liposuction from one part of the body. It is processed and then injected into the breasts to contour them. The procedure is also used in women without cancer, to improve the appearance of the breasts or enlarge them.
However, in women who have had breast cancer, doctors worry that the injected fat cells may somehow stimulate the growth of any dormant cancer cells or eventually induce new cancer cells.
There is no international agreement on the technique when used after breast cancer treatment, Petit says. In the U.S., for instance, the American Society of Plastic Surgeons Fat Graft Task Force in 2009 concluded that no studies can confirm the oncologic safety of lipofilling in cancer patients.
In the most recent study, Petit and colleagues evaluated 513 women who had 646 lipofilling procedures done from 2000 to 2010. Of the 513 women, 370 had undergone mastectomy. The other 143 had breast-conserving surgery.
Nearly 79% had invasive cancers. The other 21% had earlier stage cancer. The average age was 52.
The women were cared for at three different institutes in Italy and France.
The lipofilling was done, on average, more than three years after the surgery. The average follow-up was more than 19 months.
Overall, Petit found a complication rate lower than 3%. Most common was cell death of some of the injected fat.
During the follow-up, breast cancers were found in 5.6% of patients. When the doctors looked only at the breast that originally had the cancer, breast cancers were found in 2.4%. Recurrence was more common in those who had breast-conserving surgery. The researchers did not find that the injected fat interfered with the ability of the mammograms to detect cancer recurrence.