Are there complications with fat transfer for a person with breast cancer in family history?

Hi. I am 24 y/old and have small and slightly tuberous breasts (bra size is 32 AA). As my main goal is to enhance the shape (and increase a little bit of volume), I though fat transfer to the breast was my best choice. Recently, I've consulted with a highly recommended doctor in my town. And he told me that, as I have a history of breast cancer in my family (3 aunts, 2 cousins), It is best for me to go with implants. Besides possibly misleading mammograms what are the dangers of Fat Tranfer?

Doctor Answers 3

Fat transfer

A fat transfer itself does not increase the risk of breast cancer since fat cells, not breast cells, are transferred. However, not all fat transfers survive. Sometimes an oil cyst may develop and sometimes small areas of scar tissue from fat necrosis can occur. All these do show upon mammagram. If too many are present, a developing cancer might be obscured. With fat transfers, you may find you are getting more X-rays and even biopsies. There will be much less chance of confusion and misreading the X-ray with implants. I would recommend implants.

San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews

Are there complications with fat transfer for a person with breast cancer in family history?

Woman who have a very strong family history of breast cancer are treated differently for a few reasons. First. you are correct that the fat transfer can contribute to "abnormal" or "worrisome" findings on your future MMGs that can lead to unnecessary biopsies. The other reason why I would avoid this surgery in a patient with a history like yours is that fat transfer means that we liposuction multiple areas of your body to harvest fat. If in the future you do get dx with breast cancer, the favored way to reconstruct the breasts is to use autologous tissue specifically your abdomen (or thighs). If these areas are liposuctioned, you will then not be a candidate for this type of reconstruction. I always ask if patients have a family history of breast cancer when they come in for cosmetic liposuction or a tummy tuck.

Potential Risks of Fat Transfer to the Breast

In your case you are raising three issues: the risks of fat transfer to the breast, the consequences of fat transfer to breasts of women with a strong family history of cancer and the ability of fat transfer to correct tuberous/constricted breasts. 
Not all the fat transferred survives in the breast. As the dead fat is absorbed it may result in calcifications which on mammogram to the untrained eye may resemble those associated with early cancer. However, the vast majority of breast radiologists can differentiate between the microcalcifications of fat grafting and those of cancer. Fat grafting may be associated with larger fat necrosis and hardening of the breasts. But most importantly requires 2-4 or more operations of fat transfer. To assure maximal survival, large amounts of fat cannot be placed in the Brrast. Instead, grafting is done in incremental stages. 
As regards tuberous breasts, the key to achieving a natural attractive result is the reduction of the large Areolas and the complete release of the constricting bands giving the breasts their shape. This is usually done easier through a periareolar approach during a Breast Augmentation but can be done by hundreds of stab wounds in the breast (i.e. Rigottomies).  Finally, there is no reason why you cannot have both: a breast augmentation supplemented by fat grafting to better cover the implant and soften the look of the breasts. 
Dr. Peter A. Aldea
Memphis, TN

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 101 reviews

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