부산대학교 도서관

BACKGROUND:: Fat grafting to the reconstructed breast may result in the development of benign lesions on physical exam, prompting further investigation with imaging and biopsy. The aim of this study was to assess the influence of fat grafting on the incidence of imaging and biopsies after post-mastectomy reconstruction. METHODS:: Patients who underwent autologous or implant-based reconstruction following mastectomy from 2010-2018 were identified. Those receiving fat grafting as part of their reconstructive course were propensity matched 1:1 to those that did not with BMI, reconstruction timing, and reconstruction type as covariates in a multivariable logistic regression model. RESULTS:: A total of 186 patients were identified, yielding 93 propensity-matched pairs. Fat-grafted patients had higher incidences of palpable masses (38.0% vs. 18.3%; p=0.003) and post-reconstruction imaging (47.3% vs. 29.0%; p=0.01), but no significant difference in the number of biopsies performed (11.8% vs. 7.5%; p=0.32). Imaging was predominately interpreted as normal (BIRADS-1, 27.9%) or benign (BIRADS-2, 48.8%), with fat necrosis being the most common finding (n=20, 45.5%). No demographic, oncologic, reconstructive, or fat grafting-specific variables were predictive of receiving post-reconstruction imaging in multivariate analysis. Fat grafting was not associated with decreased 5-year overall survival or locoregional recurrence-free survival. CONCLUSIONS:: Fat grafting to the reconstructed breast is associated with increased incidences of palpable masses and subsequent post-reconstruction imaging with benign radiographic findings. While oncologically safe, both patients and providers should be aware that concerning physical exam findings can be a benign sequela of fat grafting and may lead to increased imaging after breast reconstruction.