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The Influence of Fat Grafting on Breast Imaging after Post-Mastectomy Reconstruction: A Matched Cohort Analysis.

Publication ,  Journal Article
Cason, RW; Shammas, RL; Broadwater, G; Glener, AD; Sergesketter, AR; Vernon, R; Le, E; Wickenheisser, VA; Marks, CE; Orr, J; Pyfer, BJ; Hollenbeck, ST
Published in: Plastic and reconstructive surgery
September 8, 2020

BACKGROUND:Fat grafting to the reconstructed breast may result in the development of benign lesions on physical exam, prompting further investigation with imaging and biopsy. The aim of this study was to assess the influence of fat grafting on the incidence of imaging and biopsies after post-mastectomy reconstruction. METHODS:Patients who underwent autologous or implant-based reconstruction following mastectomy from 2010-2018 were identified. Those receiving fat grafting as part of their reconstructive course were propensity matched 1:1 to those that did not with BMI, reconstruction timing, and reconstruction type as covariates in a multivariable logistic regression model. RESULTS:A total of 186 patients were identified, yielding 93 propensity-matched pairs. Fat-grafted patients had higher incidences of palpable masses (38.0% vs. 18.3%; p=0.003) and post-reconstruction imaging (47.3% vs. 29.0%; p=0.01), but no significant difference in the number of biopsies performed (11.8% vs. 7.5%; p=0.32). Imaging was predominately interpreted as normal (BIRADS-1, 27.9%) or benign (BIRADS-2, 48.8%), with fat necrosis being the most common finding (n=20, 45.5%). No demographic, oncologic, reconstructive, or fat grafting-specific variables were predictive of receiving post-reconstruction imaging in multivariate analysis. Fat grafting was not associated with decreased 5-year overall survival or locoregional recurrence-free survival. CONCLUSIONS:Fat grafting to the reconstructed breast is associated with increased incidences of palpable masses and subsequent post-reconstruction imaging with benign radiographic findings. While oncologically safe, both patients and providers should be aware that concerning physical exam findings can be a benign sequela of fat grafting and may lead to increased imaging after breast reconstruction.

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Published In

Plastic and reconstructive surgery

DOI

EISSN

1529-4242

ISSN

0032-1052

Publication Date

September 8, 2020

Related Subject Headings

  • Surgery
  • 3203 Dentistry
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

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Cason, R. W., Shammas, R. L., Broadwater, G., Glener, A. D., Sergesketter, A. R., Vernon, R., … Hollenbeck, S. T. (2020). The Influence of Fat Grafting on Breast Imaging after Post-Mastectomy Reconstruction: A Matched Cohort Analysis. Plastic and Reconstructive Surgery. https://doi.org/10.1097/prs.0000000000007327
Cason, Roger W., Ronnie L. Shammas, Gloria Broadwater, Adam D. Glener, Amanda R. Sergesketter, Rebecca Vernon, Elliot Le, et al. “The Influence of Fat Grafting on Breast Imaging after Post-Mastectomy Reconstruction: A Matched Cohort Analysis.Plastic and Reconstructive Surgery, September 8, 2020. https://doi.org/10.1097/prs.0000000000007327.
Cason RW, Shammas RL, Broadwater G, Glener AD, Sergesketter AR, Vernon R, et al. The Influence of Fat Grafting on Breast Imaging after Post-Mastectomy Reconstruction: A Matched Cohort Analysis. Plastic and reconstructive surgery. 2020 Sep 8;
Cason, Roger W., et al. “The Influence of Fat Grafting on Breast Imaging after Post-Mastectomy Reconstruction: A Matched Cohort Analysis.Plastic and Reconstructive Surgery, Sept. 2020. Epmc, doi:10.1097/prs.0000000000007327.
Cason RW, Shammas RL, Broadwater G, Glener AD, Sergesketter AR, Vernon R, Le E, Wickenheisser VA, Marks CE, Orr J, Pyfer BJ, Hollenbeck ST. The Influence of Fat Grafting on Breast Imaging after Post-Mastectomy Reconstruction: A Matched Cohort Analysis. Plastic and reconstructive surgery. 2020 Sep 8;

Published In

Plastic and reconstructive surgery

DOI

EISSN

1529-4242

ISSN

0032-1052

Publication Date

September 8, 2020

Related Subject Headings

  • Surgery
  • 3203 Dentistry
  • 3202 Clinical sciences
  • 1103 Clinical Sciences