Effects of Prophylactic Lipofilling After Radiotherapy Compared to Non–Fat Injected Breasts: A Randomized, Objective Study

Abstract

Abstract Background Patients who are suffering from invasive breast cancer may require post-mastectomy radiation therapy (PMRT). PMRT improves outcomes in breast cancer patients in terms of locoregional recurrence. Preliminary studies indicate that fat injections reduce post-radiation damage of soft tissue and implants. Objectives The aim of this study was to demonstrate the safety and effectiveness of prophylactic fat injections on radiated implanted breasts. Methods The authors randomly assigned 60 female patients to either Group A or B. Group A patients received 3 breast fat injections, according to Coleman’s technique, after radiotherapy and before expander removal with definitive implant insertion. Group B patients underwent surgery without lipofilling. At each surgical operation, skin biopsies were performed in a specific breast area to evaluate adipose tissue thickness, and a statistical analysis of the thickness variations was performed with the Wilcoxon’s sum test. Disability was assessed according to the Late Effects of Normal Tissues-Subjective Objective Management Analytic scale. Results The study demonstrates a qualitative and quantitative improvement about tissues after fat injection. This is highlighted by the significant increase in thickness after lipofilling. Conclusions The study, which is based on both clinical and histological findings and is supported by the comparison of a control group with a 1-year follow-up, demonstrates that fat injections reduce tissue radio damage, improving reconstructive surgery outcomes and quality of life. Level of Evidence: 2