Oncological Safety of Lipofilling in Healthy BRCA Carriers After Bilateral Prophylactic Mastectomy: A Case Series

The germline breast cancer gene (BRCA) mutation confers a lifetime high risk for breast cancer (BC) and bilateral prophylactic mastectomy is the procedure which allows the highest risk reduction rate. Among other techniques, lipofilling (LF) can be used for breast reconstruction of these patients. H...

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Bibliographic Details
Published in:European journal of breast health 2019-10, Vol.15 (4), p.217-221
Main Authors: Ho Quoc, Christophe, Dias, Leonardo Pires Novais, Braghiroli, Oddone Freitas Melro, Martella, Nunzia, Giovinazzo, Vincenzo, Piat, Jean-Marc
Format: Article
Language:English
Subjects:
brca mutation
breast cancer
breast reconstruction
fat grafting
lipofilling
Original
prophylactic mastectomy
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Summary:The germline breast cancer gene (BRCA) mutation confers a lifetime high risk for breast cancer (BC) and bilateral prophylactic mastectomy is the procedure which allows the highest risk reduction rate. Among other techniques, lipofilling (LF) can be used for breast reconstruction of these patients. However, there are some oncological safety concerns on the subject. The purpose of this study was to assess the oncological risk of LF in BRCA healthy patients. A single institution case series was built including BRCA I/II mutated patients with no previous history of BC, who underwent bilateral prophylactic mastectomy followed by breast reconstruction with exclusive LF or combined with implants or latissimus dorsi flap. Data were collected regarding patient demographics, clinical information, reconstruction techniques used, and fat grafting details. From September 1999 till November 2017, we identified 18 BRCA carriers with no history of BC who had undergone bilateral prophylactic mastectomy, followed by breast reconstruction with LF. A total of 36 LF procedures were performed following an implant or latissimus dorsi flap, or as an exclusive fat grafting breast reconstruction. The average number of LF sessions was 1.4 with a mean volume of 108.8cc per breast. Median follow-up was 33.0 months after mastectomy and 24.5 months after the last LF intervention; no patients were diagnosed with BC during follow-up. Germline BRCA mutation is a high-risk plight for BC. However, despite the limited follow-up, no BC was detected.
ISSN:2587-0831
2587-0831
DOI:10.5152/ejbh.2019.5013