Autologous fat graft in postmastectomy pain syndrome following breast conservative surgery and radiotherapy

Luca Maione, Valeriano Vinci, Fabio Caviggioli, Francesco Klinger, Barbara Banzatti, Barbara Catania, Andrea Lisa, Marco Klinger

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Background: Breast cancer is the most common cancer in women worldwide, affecting one in eight women. Breast-conserving surgery (BCS) has become a well-established alternative to mastectomy in the treatment of breast cancer, providing a less invasive treatment. Just as life expectancy after breast cancer has improved, so has morbidity increased. One of the most relevant and debilitating consequences of oncological breast surgery is postmastectomy pain syndrome (PMPS). Our results published in 2011 on the treatment of PMPS in patients who had undergone mastectomy and radiotherapy and our experience in scar treatment with fat grafts were the theoretical bases for this prospective study. Methods: From April 2011 to April 2012 a total of 96 patients, who had undergone lumpectomy and radiation therapy, with the diagnosis of PMPS were considered for fat grafts. We performed autologous fat grafting in 59 patients (study group), whereas 37 patients did not receive any further surgical procedure (control group). Pain assessment was performed using the visual analog scale (VAS) before and after treatment in the treated group and in the control group at the first visit and the control visit, with a mean follow-up of 10 months. Results were analyzed using the Wilcoxon rank sum test. Results: Four patients were lost to follow-up (two patients in the control group and two patients in the treated group). A significant VAS pain decrease was detected in patients treated with autologous fat grafting (3.1 point reduction, p ≤ 0.005). Conclusion: Because of the safety, efficacy, and optimal tolerability of the procedure, we believe that fat grafting can be considered useful in treating PMPS in patients who have undergone BCS and radiotherapy. Level of Evidence III: For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Original languageEnglish
Pages (from-to)528-532
Number of pages5
JournalAesthetic Plastic Surgery
Volume38
Issue number3
DOIs
Publication statusPublished - 2014

Fingerprint

Breast
Radiotherapy
Fats
Transplants
Pain
Segmental Mastectomy
Mastectomy
Pain Measurement
Breast Neoplasms
Nonparametric Statistics
Control Groups
Therapeutics
Evidence-Based Medicine
Lost to Follow-Up
Life Expectancy
Visual Analog Scale
Cicatrix
Prospective Studies
Morbidity
Safety

Keywords

  • BCS
  • Fat graft
  • Pain
  • PMPS
  • Scar

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Autologous fat graft in postmastectomy pain syndrome following breast conservative surgery and radiotherapy. / Maione, Luca; Vinci, Valeriano; Caviggioli, Fabio; Klinger, Francesco; Banzatti, Barbara; Catania, Barbara; Lisa, Andrea; Klinger, Marco.

In: Aesthetic Plastic Surgery, Vol. 38, No. 3, 2014, p. 528-532.

Research output: Contribution to journalArticle

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abstract = "Background: Breast cancer is the most common cancer in women worldwide, affecting one in eight women. Breast-conserving surgery (BCS) has become a well-established alternative to mastectomy in the treatment of breast cancer, providing a less invasive treatment. Just as life expectancy after breast cancer has improved, so has morbidity increased. One of the most relevant and debilitating consequences of oncological breast surgery is postmastectomy pain syndrome (PMPS). Our results published in 2011 on the treatment of PMPS in patients who had undergone mastectomy and radiotherapy and our experience in scar treatment with fat grafts were the theoretical bases for this prospective study. Methods: From April 2011 to April 2012 a total of 96 patients, who had undergone lumpectomy and radiation therapy, with the diagnosis of PMPS were considered for fat grafts. We performed autologous fat grafting in 59 patients (study group), whereas 37 patients did not receive any further surgical procedure (control group). Pain assessment was performed using the visual analog scale (VAS) before and after treatment in the treated group and in the control group at the first visit and the control visit, with a mean follow-up of 10 months. Results were analyzed using the Wilcoxon rank sum test. Results: Four patients were lost to follow-up (two patients in the control group and two patients in the treated group). A significant VAS pain decrease was detected in patients treated with autologous fat grafting (3.1 point reduction, p ≤ 0.005). Conclusion: Because of the safety, efficacy, and optimal tolerability of the procedure, we believe that fat grafting can be considered useful in treating PMPS in patients who have undergone BCS and radiotherapy. Level of Evidence III: For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.",
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