Imaging changes after breast reconstruction with fat grafting - retrospective study of 90 breast cancer

Objective: To evaluate the breast imaging changes after fat grafting and its impact on cancer follow up.

Methods: This is a retrospective observational study conducted on patients who underwent fat grafting for breast reconstruction. We reviewed mammographic and ultrasound images of patients. Fisher’s exact test was used to analyze results. The level of significance was set at P < 0.05.

Results: A total of ninety patients with breast cancer had fat grafting. Fifty eight patients for defects following post mastectomy reconstruction and 32 for wide local excision defects. The mean follow up was 37.4 months. Benign lumps were identified in 23/90 cases (25 percent).Mammograms were reported as BI-RADS I in 21/32 cases (72 percent) and BI-RADS II in 8/32 cases (28 percent). BI-RADs III score was reported in two patients on further follow up imaging, both were re-classified as BI-RADS II after biopsy. A total of eight patients (8.9 percent) required biopsy. No local recurrences or new cancers were observed in any patients.

Conclusion: Our study suggests radiological changes after fat grafting are almost always benign with no adverse outcome on cancer follow up.

Abbreviations:FG: Fat grafting, PMR: Post Mastectomy Reconstruction, WLE: Wide Local Excision, BI-RADS: Breast Imaging Reporting and Data system, M: Mammograms, CC: Craniocaudal, MLO: Mediolateral Oblique, MRI: Magnetic Resonance Imaging, FN: Fat Necrosis.