Oncological Safety of Lipofilling in Healthy BRCA Carriers After Bilateral Prophylactic Mastectomy: A Case Series

Abstract

Objective: Th germline breast cancer gene (BRCA) mutation confers a lifetime high risk for breast cancer (BC) and bilateral prophylactic mastectomy is the procedure which allows the highest risk reduction rate. Among other techniques, lipofiling (LF) can be used for breast reconstructionof these patients. However, there are some oncological safety concerns on the subject. Th purpose of this study was to assess the oncological risk ofLF in BRCA healthy patients.Materials and Methods: A single institution case series was built including BRCA I/II mutated patients with no previous history of BC, whounderwent bilateral prophylactic mastectomy followed by breast reconstruction with exclusive LF or combined with implants or latissimus dorsi flp.Data were collected regarding patient demographics, clinical information, reconstruction techniques used, and fat grafting details.Results: From September 1999 till November 2017, we identifid 18 BRCA carriers with no history of BC who had undergone bilateral prophylactic mastectomy, followed by breast reconstruction with LF. A total of 36 LF procedures were performed following an implant or latissimus dorsi flp,or as an exclusive fat grafting breast reconstruction. Th average number of LF sessions was 1.4 with a mean volume of 108.8cc per breast. Medianfollow-up was 33.0 months after mastectomy and 24.5 months after the last LF intervention; no patients were diagnosed with BC during follow-up.Conclusion: Germline BRCA mutation is a high-risk plight for BC. However, despite the limited follow-up, no BC was detected.