Fat transfer in breasts has been in the news over the last year. It involves removing fat in an atraumatic way from parts of the body such as hips, abdomen and thighs and re-injecting it into the breast either to enhance its volume usually by a cup size for breast augmentation or to fill small defects after breast cancer lumpectomy surgery. Great care has to be taken to transfer fat into the subcutaneous or intrapectoral planes and not to inject fat into the breast tissue itself. As the fat can re-absorb by 30- 40%, two or more ‘top-up ’operations may be required.
On MRI or mammograms, the resorption can be seen as calcification. A trained radiologist can distinguish between microcalcification arising from fat transfer vs. breast cancer. However, there is limited scientific evidence regarding the effect of stem cells, contained within the transferred fat, on breast cancer. Studies in the laboratory have shown that presence of stem cells favour the growth of tumour cells, but this has not yet been substantiated by clinical trials. The American Society of Plastic Surgeons (ASPS) has advised mammograms before and after fat transfer to provide re-assurance to the patient regarding any new abnormalities that may develop. It advises against fat transfer in cosmetic patients at high-risk of breast cancer such as those with personal or familial history of breast cancer and/or BRCA-1, BRCA-2 gene inheritance.
In the UK, guidelines from the Breast Interface group (BAPRAS and BASO) were published in 2012 are available on the link: http://www.bapras.org.uk/downloaddoc.asp?id=666.
On MRI or mammograms, the resorption can be seen as calcification. A trained radiologist can distinguish between microcalcification arising from fat transfer vs. breast cancer. However, there is limited scientific evidence regarding the effect of stem cells, contained within the transferred fat, on breast cancer. Studies in the laboratory have shown that presence of stem cells favour the growth of tumour cells, but this has not yet been substantiated by clinical trials. The American Society of Plastic Surgeons (ASPS) has advised mammograms before and after fat transfer to provide re-assurance to the patient regarding any new abnormalities that may develop. It advises against fat transfer in cosmetic patients at high-risk of breast cancer such as those with personal or familial history of breast cancer and/or BRCA-1, BRCA-2 gene inheritance.
In the UK, guidelines from the Breast Interface group (BAPRAS and BASO) were published in 2012 are available on the link: http://www.bapras.org.uk/downloaddoc.asp?id=666.
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