A case controlled study of the oncological safety of fat grafting.

: Currently there is no clinical evidence of oncological risk associated with fat grafting (FG) although its safety has been questioned based on in vitro and in vivo research. This case-controlled study was designed to investigate the risk of relapse associated with fat grafting in women with a breast cancer history. METHODS: Of 328 women with previously treated malignant breast disease who underwent fat grafting at the Nottingham Breast Institute, complete data was available for 211 (Invasive carcinoma = 184, DCIS = 27). Mean follow-up was 88 months from primary cancer surgery and 32 months following FG. Control subjects were matched 2:1 for; date of primary cancer operation (within 2 years), age (within 5 years), type of surgery, tumour histology, ER status and disease free status by time equivalent to that of fat grafting. Final endpoints were tumour recurrence and death. Outcome results were compared with a systematic review of all patients undergoing fat grafting with adequate follow-up reported in the literature. RESULTS: No significant excess oncological events were observed in patients who had FG compared to controls with regards to local (0.95% v 1.90%, p=0.33), regional (0.95% v 0%, p=0.16) and distant recurrences (3.32% v 2.61%, p=0.65). A systematic review identified case series with a total of 1573 women who had fat grafting after primary oncological breast surgery. The locoregional relapse rate for these patients was 2.92% (0.95%/year). CONCLUSIONS: This study has found no evidence of increased oncological risk associated with fat grafting in women previously treated for breast cancer.