Meta-analysis of the oncological safety of autologous fat transfer after breast cancer

BackgroundAutologous fat transfer, also known as lipofilling, is a minimally invasive technique that uses the patient's own fat to correct disfiguring sequelae after breast cancer surgery. Despite its obvious clinical benefits, experimental research has demonstrated that autologous fat transfer inherently stimulates angiogenesis and tissue regeneration, which is feared to increase the risk of locoregional recurrence of breast cancer. This meta-analysis is founded on recently completed large cohort studies on this highly relevant topic. MethodsA literature search was performed in PubMed, Embase and the Cochrane Library on 1 September 2017, adhering to the PRISMA guidelines, to identify all relevant studies of patients with breast cancer exposed to autologous fat transfer. The difference in incidence rate of locoregional recurrence between patients who had autologous fat transfer and controls was the primary outcome in the meta-analysis. ResultsFifty-nine studies and a total of 4292 patients were included. These consisted of seven matched cohorts, 12 cohorts and 40 case series. Mean follow-up was 57 years from the date of primary cancer surgery and 27 years after autologous fat transfer. Meta-analysis of matched cohorts revealed an incidence rate difference of -015 (95 per cent c.i. -036 to 007) per cent per year, which was not statistically significant (P = 0419). This finding was confirmed in the pooled results of the remaining cohorts and case series. ConclusionThis meta-analysis of all oncological data from the published literature demonstrated that autologous fat transfer did not result in an increased rate of locoregional recurrence in patients with breast cancer. Autologous fat transfer can therefore be performed safely in breast reconstruction after breast cancer. Lipofilling ok