The postoperative outcomes and oncological safety of free dermal fat graft for breast reconstruction.

Abstract

Background: Breast cancer treatment has evolved to focus on not only eradicating the disease but also enhancing the quality of life (QoL) for patients. Free dermal fat graft (FDFG) is used for immediate breast reconstruction (IBR), an emerging technique with the potential for enhanced aesthetic outcomes and improved patient satisfaction. However, concerns remain regarding complications and oncological safety. This study aims to assess the clinical effect, aesthetic outcomes, and oncological safety of FDFG compared to traditional breast-conserving surgery (TBCS) in patients with early-stage breast cancer.

Methods: In this retrospective study, data from a total of 106 breast cancer patients were collected with 52 in the FDFG group and 54 in the TBCS group. Follow-up evaluations occurred at six months, one and three years after the surgery, encompassing physical examinations, imaging studies, and tumor markers for monitoring the recurrence or metastasis. The cosmetic outcomes were based on the Breast Cancer Patient-Reported Outcomes Questionnaire (BREAST-Q).

Results: Despite longer operation time, more severe intraoperative bleeding, and greater postoperative drainage volumes in the FDFG group, the complication rates did not differ significantly between the groups. FDFG patients reported significantly higher scores in satisfaction with the breasts and psychosocial well-being in the BREAST-Q survey. There were no significant differences in survival rates, local recurrence rates, regional recurrence rates, or distant metastasis rates. Serum tumor markers decreased postoperatively, with no significant difference observed between the two groups.

Conclusions: In this retrospective study, the short-term cosmetic outcome of FDFG was superior to that of TBCS, and patient satisfaction was higher. There was no significant difference in survival, local recurrence, nor distant metastasis. Nevertheless, further prospective studies are necessary to validate these findings regarding oncological safety.