Am I candidate for breast fat transfer if I have fibrocystic breast disease, very dense breast tissue, and had a benign lump?

Question

I have fibrocystic breast disease. I had 1 suspicious lump biopsied but it was benign. I have extremely dense breast tissue. I know breast fat transfer may cause calcifications and cysts due to some of transferred fat dying, which can make breast cancer detection trickier. Since I already have fibrocystic, I wasn’t sure if that would cause further difficulty in breast cancer detection if I got a fat transfer. I was also concerned the fat transfer may cause more breast lumps. Don't want implants.

Rodger Shortt, FRCSC · Answer

You have listed very accurately what happens with fat grafting.  In your situation I think that you should have a discussion with your surgeon to determine if fat grafting to the breast is the best choice for you, or if an implant might be better.

Harry T. Haramis, MD, FACS · Answer

Personally, in your case, you may want to consider breast implants. Fat that is transferred can become dense and calcified and mimick pre malignant changes on mammograms. In that case, biopsies may be indicated. Implants would be placed below the breast and should avoid this issues.An exam and consultation with a plastic surgeon is recommended to discuss your options and expectations.

John J. O'Brien, MD · Answer

Hello, thank you for your question. I would recommend that you have a current normal mammogram prior to any fat injections. Heading fibrocystic disease is not usually a problem for this procedure. Seek out a  qualified board certified plastic surgeon in your area to discuss all of your options and followup questions. Best of luck.

Kenneth Hughes, MD · Answer

In and of itself, fibrocystic disease should not impact breast augmentation or the outcome of the surgery.  You should continue with annual mammograms for early detection of any breast lumps.

Robert B. Louton, MD · Answer

Fat injections to the breast can be successful.  But to get enough volume to have a meaningful result usually requires multiple sessions.  Serial injections can be costly and this fact can make implant augmentation more attractive. 
Mammographic appearance of fat is frequently indistinguishable from normal breast.  The dystrophic calcifications that can occur from fat injections are different in nature from those found in cancer.  Oil cysts from fat also have a distinct appearance.
Thus far the jury is out with regards to cancer detection and fat augmentation.  The data is sparse but I would predict fat demonstrates less obstruction to mammography then implants.  So it is not unreasonable to proceed with fat from that standpoint. 
Fibrocystic disease poses minor technical problems with fat injections but otherwise is not a contraindication.
I hope this helps.

Am I candidate for breast fat transfer if I have fibrocystic breast disease, very dense breast tissue, and had a benign lump?

Answers (5)

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