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EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
EASO2011 BRS 10 Petit
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EASO2011 BRS 10 Petit

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  • 1. LIPOFILLING AFTER BREASTLIPOFILLING AFTER BREAST CANCERCANCER JY Petit IEO Milan
  • 2. Fat transferFat transfer • Plastic surgery revolutionPlastic surgery revolution • Multiple indicationsMultiple indications (Aesthetic surgery)(Aesthetic surgery) • Oncologic safety ?Oncologic safety ?
  • 3. Conservative treatment improvement Fat injection -results
  • 4. Implant reconstruction 50 gm – Local anesthesia
  • 5. Immediate Pre-op Intraop after debridement 25 Days Post Op 41 Days Post Op Intra-op after Cell Tx 14 Days Post Op 90 y old women 40 years after abdominal radiation therapy and non healing sacral pressure sore 90% cells to circular area around sore 10% cells to sore itself G. Rigotti
  • 6. Pressure Sore-Day 145
  • 7. Cell Enhanced Autologous Fat Graft Not FDA approved Cell isolation Washing Combine to Cell Enhanced Fat Graft 50% 50% Michael Sheflan 09
  • 8. when transferring thewhen transferring the specimenspecimen inin Breast cancerBreast cancer patientspatients ? Are we sure of Cancer safety 2010
  • 9. «… no study suggesting an increasing risk of recurrence. But no study with high level of evidence » « No solid results in the literature: the task force cannot give any spécific recommendation »
  • 10.  109 references  8 clinical series
  • 11. Few cancer reconstructions No oncologic dataShort Follow up No data on oncologic safety No oncological FU
  • 12. Oncologic eventsOncologic events were comparablewere comparable ““Before” and “After”Before” and “After” grafting periodgrafting period Relevance ?Relevance ? Comparable ?Comparable ? Oncologic event ?Oncologic event ? ?!
  • 13.  De Lorenzi F, Lohsiriwat V, Petit JY.De Lorenzi F, Lohsiriwat V, Petit JY.  In Response To: Rigotti G, Marchi A, Stringhini P et al.In Response To: Rigotti G, Marchi A, Stringhini P et al. "Determining the Oncological Risk of"Determining the Oncological Risk of Autologous Lipoaspirate Grafting for Post-Mastectomy Breast Reconstruction".Autologous Lipoaspirate Grafting for Post-Mastectomy Breast Reconstruction".  Aesthetic Plast Surg. 2011 Feb;35(1):132-3.Aesthetic Plast Surg. 2011 Feb;35(1):132-3. I II Period I and II are “NOT” comparable U.Veronesi NEJM 2002 October B. Fisher NEJM 2002 October Lipofilling
  • 14. selection of fundamental research publications 41 articles Published between 1992 and 2009 Search > 100 papers Breast. 2011 Feb 4. Autologous fat transplantation in patients with breast cancer: "silencing" or "fueling" cancer recurrence? Lohsiriwat V, Curigliano G, Rietjens M, Goldhirsch A, Petit JY. IEO recent clinical studyIEO recent clinical study
  • 15. Adipocytes produce adipokines (leptines, growth factors etc. ) Stimulates angiogenesis and cancer cell growth Endocrine, Paracrine, Autocrine action
  • 16. IEO recent clinical studyIEO recent clinical study 2010 in JPRAS 2011 in PRS (August 2011)
  • 17. First study (Oct 2005- July 2008) Lipofilling of the breast 194 cases using Coleman technique 114 after mastectomy 77 after conservative treatment (26 patients underwent several injections)
  • 18. Complications rates 3,6%
  • 19. Mammografic modifications post lipofilling: 4 cases benign aspect no biopsy Local recurrence: 1 case (find out 8 days after LF)
  • 20. No definitive conclusion need of a prospective clinical study with a control group to demonstrate statistically the safety of the lipofilling
  • 21. •1997-20081997-2008 •321 breast cancer patients who321 breast cancer patients who subsequently underwent lipofillingsubsequently underwent lipofilling •2:1 matched-patients with similar2:1 matched-patients with similar characteristics who did notcharacteristics who did not undergo a lipofilling.undergo a lipofilling. Annals of Oncology (accepted)
  • 22. Matching criteriae
  • 23. Overall incidence – comparable excepts in “In Situ” cancer
  • 24. CONCLUSION 1. No evidence of increasing risk of LRR after Lipofilling (In situ group?) 2- Final results after longer FU of prospective control studies (in situ cases) 3- Special focus on the techniques of stem cells selection (Cytori) and growth factor addition (Japan)
  • 25. International workshop on Cancer and Breast Reconstructive Live surgery & interactive Video sessions 20-22June 2011 Information and contact on IEO website Full HD 3D transmission « ieo-breastcancer.com »

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