Camile Cesa Stumpf

Immediate reconstruction with autologous fat grafting: influence in loco regional recurrence in breast cancer

Objective to evaluate local and systemic recurrence of breast cancer in patients submitted to autologous fat grafting in the immediate reconstruction after conservative surgery for breast cancer. Methods this is a historical cohort study comparing 167 patients submitted to conservative surgery without reconstruction (conservative surgery group) with 27 patients submitted to conservative treatment with immediate graft reconstruction, following the Colemans technique (lipofilling group). All patients had invasive carcinoma and were operated by a single surgeon from 2004 to 2011. The postoperative follow-up time was 36 months. Results the overall incidence of local recurrence was 2.4%. No patient in the lipofilling group had local recurrence during the study period. For systemic recurrence, the rates obtained were 3.7% (one patient) for the fat grafting group and 1.8% (three patients) for the conservative surgery group without reconstruction. Conclusion there was no significant difference for local or systemic recurrence in the groups studied. Immediate autologous fat grafting appears to be a safe procedure..................................................................................................... 14 INTRODUÇÃO ................................................................................................ 16 REVISÃO DA LITERATURA ........................................................................... 19 1 Estratégias para localizar e selecionar as informações ............................ 19 1.1 Marco conceitual esquemático .......................................................... 20 2 Cirurgia conservadora .............................................................................. 20 3 Enxerto autólogo de gordura .................................................................... 25 3.1 Lipoenxertia ....................................................................................... 25 3.2 Biologia .............................................................................................. 25 3.3 Técnica .............................................................................................. 27 3.4 Conceito de enxerto estruturado de gordura de Coleman ................. 29 3.5 Indicações ......................................................................................... 33 3.6 Risco oncológico................................................................................ 34 3.7 Seguimento Radiologico .................................................................... 40 JUSTIFICATIVA .............................................................................................. 42 HIPÓTESES ................................................................................................... 43 OBJETIVOS .................................................................................................... 44 REFERÊNCIAS .............................................................................................. 45 ARTIGO EM INGLÊS...................................................................................... 53

Immediate reconstruction with autologous fat grafting: influence in breast cancerregional recurrence

Objective to evaluate local and systemic recurrence of breast cancer in patients submitted to autologous fat grafting in the immediate reconstruction after conservative surgery for breast cancer. Methods this is a historical cohort study comparing 167 patients submitted to conservative surgery without reconstruction (conservative surgery group) with 27 patients submitted to conservative treatment with immediate graft reconstruction, following the Colemans technique (lipofilling group). All patients had invasive carcinoma and were operated by a single surgeon from 2004 to 2011. The postoperative follow-up time was 36 months. Results the overall incidence of local recurrence was 2.4%. No patient in the lipofilling group had local recurrence during the study period. For systemic recurrence, the rates obtained were 3.7% (one patient) for the fat grafting group and 1.8% (three patients) for the conservative surgery group without reconstruction. Conclusion there was no significant difference for local or systemic recurrence in the groups studied. Immediate autologous fat grafting appears to be a safe procedure..................................................................................................... 14 INTRODUÇÃO ................................................................................................ 16 REVISÃO DA LITERATURA ........................................................................... 19 1 Estratégias para localizar e selecionar as informações ............................ 19 1.1 Marco conceitual esquemático .......................................................... 20 2 Cirurgia conservadora .............................................................................. 20 3 Enxerto autólogo de gordura .................................................................... 25 3.1 Lipoenxertia ....................................................................................... 25 3.2 Biologia .............................................................................................. 25 3.3 Técnica .............................................................................................. 27 3.4 Conceito de enxerto estruturado de gordura de Coleman ................. 29 3.5 Indicações ......................................................................................... 33 3.6 Risco oncológico................................................................................ 34 3.7 Seguimento Radiologico .................................................................... 40 JUSTIFICATIVA .............................................................................................. 42 HIPÓTESES ................................................................................................... 43 OBJETIVOS .................................................................................................... 44 REFERÊNCIAS .............................................................................................. 45 ARTIGO EM INGLÊS...................................................................................... 53

Reconstrução imediata com enxerto autólogo de gordura : influência na recorrência local de câncer de mama

Objective to evaluate local and systemic recurrence of breast cancer in patients submitted to autologous fat grafting in the immediate reconstruction after conservative surgery for breast cancer. Methods this is a historical cohort study comparing 167 patients submitted to conservative surgery without reconstruction (conservative surgery group) with 27 patients submitted to conservative treatment with immediate graft reconstruction, following the Colemans technique (lipofilling group). All patients had invasive carcinoma and were operated by a single surgeon from 2004 to 2011. The postoperative follow-up time was 36 months. Results the overall incidence of local recurrence was 2.4%. No patient in the lipofilling group had local recurrence during the study period. For systemic recurrence, the rates obtained were 3.7% (one patient) for the fat grafting group and 1.8% (three patients) for the conservative surgery group without reconstruction. Conclusion there was no significant difference for local or systemic recurrence in the groups studied. Immediate autologous fat grafting appears to be a safe procedure..................................................................................................... 14 INTRODUÇÃO ................................................................................................ 16 REVISÃO DA LITERATURA ........................................................................... 19 1 Estratégias para localizar e selecionar as informações ............................ 19 1.1 Marco conceitual esquemático .......................................................... 20 2 Cirurgia conservadora .............................................................................. 20 3 Enxerto autólogo de gordura .................................................................... 25 3.1 Lipoenxertia ....................................................................................... 25 3.2 Biologia .............................................................................................. 25 3.3 Técnica .............................................................................................. 27 3.4 Conceito de enxerto estruturado de gordura de Coleman ................. 29 3.5 Indicações ......................................................................................... 33 3.6 Risco oncológico................................................................................ 34 3.7 Seguimento Radiologico .................................................................... 40 JUSTIFICATIVA .............................................................................................. 42 HIPÓTESES ................................................................................................... 43 OBJETIVOS .................................................................................................... 44 REFERÊNCIAS .............................................................................................. 45 ARTIGO EM INGLÊS...................................................................................... 53

Lipofiling Adds Diagnostic Difficulties in Imaging Evaluation After Radiotherapy? Case-Control Study

INTRODUCTION: Immediate autologous fat grafting has yet to be assessed as an alternative for breast reconstruction following conserving surgery. The present study sought to compare mammographically, patients undergoing conserving surgery with patients undergoing autologous adipose tissue immediately to conserving surgery, after completion of radiation. MATERIALS AND METHODS: This is a case-control study. The convenience sampling occurred between June 2010 and Dec 2011, where 28 patients coming from the outpatient Breast Care Unit with the indication of breast conserving surgery underwent breast reconstruction with fat grafting. Controls were consecutive cases, 60 patients, of conservative surgery that occurred in the same period. After the surgical procedure, all were subjected to radiotherapy. All patients underwent clinical and radiological evaluation at 6 months. RESULTS: The results of early evaluation in six months, showed no difference between the mammographic findings in patients undergoing conservative surgery and conventional surgical repair with fat grafting. CONCLUSION: Immediate autologous fat grafting is a promising technique for reconstruction after breast-conserving surgery. The evaluation performed by an observer who did not contain the information of the fat grafting technique has been shown that increased degree of harder it not for the diagnosis of changes in mammographic post surgery patients submitted to this technique. KEYWORDS: Autologous fat grafting; breast-conserving surgery; breast reconstruction; lipofilling; breast cancer.