New data provide reassurance about the safety of autologous fat transfer (AFT) for breast reconstruction following surgery for breast cancer. AFT, also known as fat grafting uses fat from another part of the body, often the abdomen, flanks, or thighs. 

The fat is removed by liposuction, processed, and then injected into the breast. This technique should now I am offered patients with the third option along with the standard approaches of breast implants and tissue flap reconstruction, say experts commenting on the new data in an editorial published online October 10 in  JAMA Surgery.

Roger K. Khouri, MD, of the Miami Breast Center, in Key Biscayne, Florida, and colleagues commented that "as in much of medicine, there is no superior option."

However, the editorialists also say that the drawbacks associated with the two standard reconstruction techniques have led many breast cancer patients to opt out of reconstruction entirely.

"Now that AFT has been proven safe and effective, the standard of care should reflect this latest addition," they say, adding that plastic surgeons should present all three options to patients who are undergoing a mastectomy.

New Data on AFT

The new data on AFT come from a retrospective study published online October 10 in  JAMA Surgery. Lead author Todor Krastev, MD, of Maastricht University Medical Center, the Netherlands, and colleagues note that AFT has become an invaluable tool for correcting tissue deformities after breast cancer surgeryHowever, clinical studies into the oncologic safety of AFT vs. conventional breast reconstruction have produced conflicting results, they note.

"Two main factors have restricted application of AFT in patients with breast cancer: the fear that it can interfere with breast cancer imaging, and that intentionally placing regenerative cells in a previous tumor bed could increase the risk of locoregional recurrence, "the investigators say.

The current study is the first in which there was a 5-year follow-up of patients who underwent AFT; they point out. They note that the study was designed to provide evidence as to whether AFT increases the risk of breast cancer recurrence.

For the study, the team used the patient database at the Tergooi Hospital in Hilversum, the Netherlands, to identify 287 patients with breast cancer (300 affected breasts) who received AFT between 2006 and 2014.

Each AFT patient was matched for age, type of oncologic surgery, tumor invasiveness, disease stage, and locoregional, recurrence-free interval at baseline with 300 breast cancer patients who served as control patients. The mean age was 48.1 years for patients undergoing AFT and 49.4 years for control patients.