The SOFCPRE National Congress on Wednesday, November 24, 2011 addressed the issue of fat transfer in the breast.
PREAMBLE
Fat transfer in the breast is currently recognized as a highly effective technique. To be performed in accordance with scientific evidence, it must be performed in a surgical setting by a plastic surgeon or by a surgeon specifically trained in this technique. Performing this technique outside of the previously defined surgical setting is considered unsafe for patients.
Several recommendations have emerged from the discussions and scientific work, depending on the clinical situation:
RECOMMENDATIONS
1°) In cases of breast reconstruction after total mastectomy, the technique is considered a surgical option both to improve tissue quality and to help reconstruct breast volume. Since recurrence after mastectomy is always possible, the surgeon should perform a preoperative clinical examination for any subcutaneous cellular tissue irregularities or skin nodules. An ultrasound scan of the chest wall may also be requested before surgery to rule out a progressive lesion. If there is any doubt, a microbiopsy will be performed beforehand. Similarly, any swelling that increases in volume at a distance from the fat transfer should be examined ultrasonographically with a microbiopsy if there is any doubt.
In the contralateral breast, it is currently not recommended to use this technique outside of multidisciplinary teams that can provide close and safe senological follow-up.
2°) In cases of partial breast reconstruction for sequelae of conservative treatment after lumpectomy, given the significant spontaneous risk of local recurrence and the more difficult clinical diagnosis of a possible local recurrence, the technique may be proposed with the following reservations:
It can only be performed after at least 3 years of clinical and radiologic surveillance by multidisciplinary teams trained in breast cancer treatment and radiologic follow-up.
3°) In cases of breast augmentation for congenital malformations or for cosmetic purposes without cancerous pathology, this technique is considered a surgical option in cases of low risk of coincidence with breast cancer (women under 35 years of age with no personal or family history of breast cancer). A preoperative radiologic workup (ultrasound and mammography) performed by a trained radiologist is considered essential, and normality (ACR1 or ACR2) is the prerequisite for performing this procedure.
SoFCPRE recommends that the patient commit to having a baseline imaging assessment one year after the procedure, if possible by the same radiologist, and to remain under regular medical supervision.
SoFCPRE offers corresponding information sheets for all these situations, as well as a national computerized collection of data provided by its members.
