In response to: Rigotti G, Marchi A, Stringhini P et al. 'Determining the oncological risk of autologous lipoaspirate grafting for post-mastectomy breast reconstruction'. Aesth Plast Surg 2010; 34: 475.

摘要

With reference to the article in question [1], we add a few considerations. We agree with the authors that despite the increasing interest in autologous fat grafting for breast reconstruction, the potential effects of lipoaspirates near or in the tumor bed are currently unclear. The biologic interaction of the lipoaspirate graft in the breast paren-chymal tissue is not well understood, and we appreciate the authors' effort to assess the eventual risks and safety of fat grafting for breast cancer patients. With regard to the mentioned series, we wonder why the authors selectively included only modified radical mastectomy patients and excluded 104 conservative breast surgery patients. At the conclusion of conservative surgery, the glandular tissue remaining after tumor removal is at higher risk of relapse than the skin and thoracic wall after a modified radical mastectomy. Moreover, it has been demonstrated that approximately 85% of breast relapses after conserving surgery are confined to the same quadrant of the breast as the primary tumor [2]. Fat grafting is used to correct postquad-rantectomy defects. Therefore, patients who underwent conservative surgery and required defect correction are the best candidates for an understanding of the interaction between fat grafting and breast parenchymal tissue.