{"title":"双侧预防性乳房切除术后健康BRCA携带者脂肪填充的肿瘤学安全性:一个病例系列。","authors":"Christophe Ho Quoc, Leonardo Pires Novais Dias, Oddone Freitas Melro Braghiroli, Nunzia Martella, Vincenzo Giovinazzo, Jean-Marc Piat","doi":"10.5152/ejbh.2019.5013","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>Germline BRCA mutation is a high-risk plight for BC. However, despite the limited follow-up, no BC was detected.</p>","PeriodicalId":91975,"journal":{"name":"The journal of breast health","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6776124/pdf/","citationCount":"5","resultStr":"{\"title\":\"Oncological Safety of Lipofilling in Healthy BRCA Carriers After Bilateral Prophylactic Mastectomy: A Case Series.\",\"authors\":\"Christophe Ho Quoc, Leonardo Pires Novais Dias, Oddone Freitas Melro Braghiroli, Nunzia Martella, Vincenzo Giovinazzo, Jean-Marc Piat\",\"doi\":\"10.5152/ejbh.2019.5013\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>Germline BRCA mutation is a high-risk plight for BC. However, despite the limited follow-up, no BC was detected.</p>\",\"PeriodicalId\":91975,\"journal\":{\"name\":\"The journal of breast health\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6776124/pdf/\",\"citationCount\":\"5\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The journal of breast health\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5152/ejbh.2019.5013\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The journal of breast health","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5152/ejbh.2019.5013","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Oncological Safety of Lipofilling in Healthy BRCA Carriers After Bilateral Prophylactic Mastectomy: A Case Series.
Objective: 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.
Materials and methods: 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.
Results: 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.
Conclusion: Germline BRCA mutation is a high-risk plight for BC. However, despite the limited follow-up, no BC was detected.