Oncological safety of breast cancer patients undergoing free-flap reconstruction and lipofilling
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Updated: Apr 15, 2026
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
1Department of Plastic and Reconstructive Surgery, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain.
Background:
Autologous fat grafting is a widely accepted approach for breast reconstruction after mastectomy but its oncological safety has not been established. This study aimed to compare recurrence in patients who underwent fat-grafting procedures after autologous breast reconstruction and those who did not.
Patients And Methods:
We retrospectively reviewed 207 consecutive patients, who underwent mastectomy and reconstruction using free flap surgery. We divide them in two groups: a study group of patients who underwent fat grafting procedure and a control group of patients who did not. Outcome regarding local and regional recurrence was compared between the two groups. Particularly, we studied recurrences from primary surgery to baseline (first lipofilling) and from baseline to most recent follow-up.
Results:
Median follow-up was 60 months from surgery to baseline and 29 months from baseline to most recent follow-up. The overall observational period after mastectomy in the control group was 120 months. Local recurrence was observed in 6 patients from the study group, respectively 3 in the first observational period and 3 after the fat grafting procedure. The control group, as the study one, presented a total of 6 recurrences (p = 0.555; Hazard Ratio free flap and lipo vs only free flap: = 0.66; 95% CI 0.16-2.66).
Conclusions:
We found no significant differences in recurrence between patients who underwent fat grafting and those who did not. These encouraging findings support previous results but larger series of patients are required to confirm long-term oncological safety in these procedures.
