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Palpable Nodules After Autologous Fat Grafting in Breast Cancer Patients: Incidence and Impact on Follow-up.

  • Original Article
  • Breast Surgery
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Abstract

Introduction

Autologous fat grafting (AFG) is a promising breast reconstruction technique, following surgery. However, fat necrosis after AFG can cause palpable nodules, inducing anxiety and prompting additional investigations. We aimed to determine the occurrence rate and to identify the risk factors of palpable nodules in breast cancer patients prompting complementary explorations.

Materials and methods

We retrospectively reviewed the computerized files of consecutive breast cancer patients who underwent AFG after mastectomy or breast conservative treatment (BCT) at our center from January 2013 to December 2016. We collected data regarding palpable nodule incidences and suspicious breast imaging findings that led to additional explorations.

Results

Of the 252 patients reviewed, 222 (88%) underwent AFG for breast reconstruction, while 30 (12%) underwent AFG for correction of defects after BCT. The follow-up period ranged from 0 to 74 months (median: 27 months), and 201 patients had follow-ups beyond 1 year. Of the 252 patients, 66 (26.2%) underwent at least one control imaging and 24 (10%) underwent a biopsy, including 6 (2.4%) locoregional recurrence. Sixty patients (24%) were diagnosed with nodules during follow-ups. Among them, 52 (87%) patients had additional imaging, and 17 patients (28%) had a biopsy, including 82% benign histology. Patients with BCT had significantly more palpable nodules at 1 year than patients who underwent total mastectomy (odds ratio = 2.50, 95% confidence interval: 1.04. 6.03, p = 0.04).

Conclusion

This study underlines the importance of preoperative patient information. This intervention and its follow-up should be reserved for experienced teams to limit unnecessary additional explorations.

Level of Evidence IV

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Authors and Affiliations

  1. Department of Obstetrics, Jeanne de Flandre University Hospital, Avenue Eugène Avinée, 59000, Lille, France

    Pauline DILE

  2. Department of Surgery, Centre Oscar Lambret, Lille, France

    Karine HANNEBICQUE, Claudia REGIS, Loïc BOULANGER & Marie-Pierre CHAUVET

  3. Department of Surgery, Institut de cancérologie de l’Ouest, Saint Herblain, France

    Céline RENAUDEAU

  4. Biostatistics Unit, Centre Oscar Lambret, Lille, France

    Émilie BOGART

  5. Department of imaging, Centre Oscar Lambret, Lille, France

    Luc CEUGNART

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  1. Pauline DILE
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DILE, P., HANNEBICQUE, K., RENAUDEAU, C. et al. Palpable Nodules After Autologous Fat Grafting in Breast Cancer Patients: Incidence and Impact on Follow-up.. Aesth Plast Surg 47, 503–511 (2023). https://doi.org/10.1007/s00266-021-02530-x

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