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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

4333 - Oncological outcome of fat grafting for breast reconstruction after cancer

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Presenters

Gaia Griguolo

Citation

Annals of Oncology (2018) 29 (suppl_8): viii58-viii86. 10.1093/annonc/mdy270

Authors

G. Griguolo1, F. Miglietta1, M.V. Dieci1, V. Vindigni2, F. Bassetto2, E. De Antoni2, I. Polico3, A. Marchet4, E. Baldan3, G. Vernaci1, T. Saibene5, S. Michieletto5, V. Guarneri1

Author affiliations

  • 1 Department Of Surgery, Oncology And Gastroenterology, University of Padova, Istituto Oncologico Veneto IRCCS, 35128 - Padova/IT
  • 2 Plastic Surgery Clinic, University of Padova, 35100 - Padova/IT
  • 3 Diagnostic Senology Unit, Istituto Oncologico Veneto - IRCCS, 35128 - Padova/IT
  • 4 Clinica Chirurgica 1, Azienda Ospedaliera di Padova, 35100 - Padova/IT
  • 5 Breast Surgery Unit, Istituto Oncologico Veneto - IRCCS, 35128 - Padova/IT
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Resources

Abstract 4333

Background

Fat grafting (FG) has become widely used in breast reconstruction after breast cancer (BC). FG might express protumorigenic factors or alter radiological aspect of the breast, raising some concerns on its oncological safety. The aim of the study was to describe clinical outcome of patients (pts) undergoing FG.

Methods

Records of 424 pts who underwent FG between 2010 and 2017 at the Plastic Surgery Dept. of Padova University were reviewed. Pts without invasive BC or not followed at Istituto Oncologico Veneto were excluded, leaving 206 pts for analysis. Cumulative Incidence of relapse was calculated from first FG. Association between clinico-pathological factors and relapse was explored.

Results

Patients were mostly post-menopausal (n = 115, 56%) and the majority had HR+/HER2- BC (n = 134, 65%). Eight pts (4%) were BRCA-mut carriers. Disease stage at diagnosis was: I (42%), II (34%), III (24%). Median interval from surgery to first FG was 23 months (range 0-257). 336 FG interventions were performed (median per patient: 1, range 1-9). At median follow-up of 38.9 months, 35 pts relapsed (10 locoregional, 25 distant relapses). Cumulative Incidence of relapse according to clinico-pathological subgroups is reported in the table. Semestral hazard rates of relapse in the three years after FG were: 0.010, 0.053, 0.034, 0.007, 0.039, and 0.038, respectively. 59 pts (29%) underwent additional breast imaging over standard recommendation (range 1-6 per patient), and 40 (20%) pts underwent breast biopsies (range 1-4, 10 confirmed a local recurrence).Table: 256P

Clinicopathological factorsNumber of patients (%)3-years cumulative incidence of relapseHazard Ratio (95% CI)
HR statusHR negative26 (13%)13%ref
HR positive170 (87%)16%1.57 (0.47-5.18)
HER2 statusHER2 positive46 (24%)10%ref
HER2 negative143 (76%)16%1.93 (0.74-2.05)
Stage at diagnosisStage I81 (42%)11%ref
Stage II67 (34%)17%2.84 (1.06-7.62)
Stage III47 (24%)23%4.42 (1.68-11.63)
Interval from surgery to first FG>2 years99 (48%)16%ref
<2 years107 (52%)17%1.07 (0.55-2.08)
Type of breast surgeryMastectomy180 (87%)15%ref
Conservative26 (13%)25%1.53 (0.63-3.69)
Overall Population206 (100%)17%-

Conclusions

This study describes a not negligible rate of recurrence in BC pts receiving FG, especially in stage III and conservative surgery pts. High risk of relapse in the first years after FG might suggest a potential relation between the procedure and events. Moreover, a significant proportion of pts underwent additional breast imaging and biopsies, which can adversely affect quality of life. A careful discussion in multidisciplinary setting is crucial for proper pts selection.

Clinical trial identification

Legal entity responsible for the study

Valentina Guarneri.

Funding

Has not received any funding.

Editorial Acknowledgement

No editorial assistance was provided by a third party for the abstract.

Disclosure

All authors have declared no conflicts of interest.

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