Systematic review: The oncological safety of adipose fat transfer after breast cancer surgery. (February 2017)

• Record Type: Journal Article
• Authors: Waked, Karl; Colle, Julien; Doornaert, Maarten; Cocquyt, Veronique; Blondeel, Phillip
• Is Part Of: Breast. Volume 31(2017)
• Page Start: 128
• Page End: 136
• Publication Date: 2017-02
• Subjects: Lipofilling -- Adipose fat transfer -- Breast cancer -- Oncology -- Oncostatin M; AFT autologous fat grafting -- BCT breast conservative therapy -- MST mastectomy -- ADMSC adipose derived mesenchymal stem cells -- LRR loco-regional recurrence rate -- CAF cancer-associated fibroblasts -- OSM Oncostatin M; Breast -- Diseases -- Periodicals; Breast -- Tumors -- Periodicals; Breast -- Periodicals; Electronic journals; Periodicals; 616
• DOI: 10.1016/j.breast.2016.11.001
• Languages: English
• ISSNs: 0960-9776

Abstract

Abstract: Objectives: Oncological concerns have risen around the safety of adipose fat transfer (AFT) after breast cancer surgery. In this article, we present the clinical and molecular evidences, and discuss the current contradiction between them. Materials and methods: Every clinical trial and experimental study on AFT and its oncological influences was screened. Between September 2014 and September 2016, 856 articles from four databases were found. 105 core articles were selected. Results: A total of 18 clinical studies have been published. The loco-regional recurrence (LRR) incidence rates range between 0 and 3.90% per year. For the mastectomy and breast conservative therapy group separately, a LRR per year between 0 and 1.62% and 0–3.90 has been reported, respectively. Some studies included a matched control group and found no significant difference between cases and controls, with the exception of a subgroup of patients with intraepithelial breast carcinoma. Adipose derived mesenchymal stem cells have a potential oncogenic effect on residual cancer cells after breast cancer surgery. Numerous signalling proteins and pathways have been described that can stimulate tumour initiation and growth. Conclusion: There is a contradiction between experimental and clinical findings. Numerous adipokines have been discovered that could potentially promote tumour initiation and growth, but clinical studies fail to point out a significant increase in LRR in patients who receive AFT after breast cancer surgery. More prospective studies are needed with a sufficient follow-up time and analysis of some critical factors, such as adjuvant radiotherapy and hormonal therapy, the origin and volume of the injected fat, and genetic influences. Highlights: Numerous adipokines have been discovered that could promote tumour initiation and growth. There is no significant increase in LRR in patients who receive AFT after breast cancer surgery. Prospective studies are needed with a sufficient follow-up time and analysis of critical factors. Current setup of experimental studies makes extrapolation of their results to in vivo impossible. Patients who opt for AFT should receive careful preoperative screening and examination.