Adipocyte and Stem Cell Grafting: Impact on Cancer Detection

Lipoaugmentation patients

Breast reduction patients

Patients, n

Age, year (mean ± SD)

35.9 ± 9.9

50.0 ± 8.9

Right breast volume change, mean ± SD

267.2 ± 36.1 cc injected

943.7 ± 905.1 g removed

Left breast volume change, mean ± SD

260.0 ± 53.8 cc injected

820.0 ± 806.3 g removed

Table 41.2

Rates of radiologic findings across all readings

	Breast reduction (n = 184)	Lipoaugmentation (n = 216)	P
Oil cysts	58 (31.5 %)	55 (25.5 %)	0.18
Scarring	158 (85.6 %)	38 (17.6 %)	<0.001
Calcifications, benign/fat necrosis	50 (27.2 %)	37 (17.1 %)	0.02
Calcifications warranting biopsy	3 (1.6 %)	10 (4.6 %)	0.16
Mass or distortion warranting biopsy	25 (13.6 %)	6 (2.8 %)	<0.001

Table 41.3

Breast imaging reporting and data system score across readings

BI-RADS Score	1	2	3	4	5
Breast reduction	9 (4.9 %)	130 (70.7 %)	19 (10.3 %)	26 (14.1 %)	0 (0.0 %)
Lipoaugmentation	78 (36.1 %)	114 (52.8 %)	10 (4.6 %)	14 (6.5 %)	0 (0.0 %)

Table 41.4

Radiologist follow-up recommendations

	12-month follow up	6-month follow up	Biopsy
Breast reduction	76 (41.3 %)	80 (43.5 %)	28 (15.2 %)
Lipoaugmentation	11 (5.1 %)	191 (88.4 %)	14 (6.5 %)

Fig. 41.1

(a) A breast reduction scar on mammography image. (b) Fat necrosis and formation of oil cyst secondary to breast reduction procedure. (c) A mammogram from lipoaugmentation with evidence of oil cyst formation

The evidence supporting the practice of fat grafting in the breast suggests that cancer screening can be effectively performed.

41.6 Conclusions

Despite controversy concerning cancer detection, current evidence supports the concept that effective screening can be preformed.

41.7 Future Direction

The promising potential of adipose-derived stem cells (ADSCs) harvested during liposuction is an area of great interest. The potential clinical utility of these cells in the treatment of patients who present with a breast deformity after segmental mastectomy (lumpectomy) and radiation therapy has been described, but not studied in a rigorous, prospective manner. The challenge at hand is to collect well-controlled data.

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