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2008 Annual Meeting Abstracts

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Lipoaspirate transplant to treat Breast Conservative Treatment side effects:evaluation of the risk to develop calcifications
Gino Rigotti, M.D.1, Alessandra Marchi, MD1, Stefania Montemezzi, MD1, Mirco Galič, MD2, Alessandro Battistoni, MD1, Andrea Sbarbati, MD2.
1Azienda Ospedaliera Verona-Italy, Verona, Italy, 2Universitā di Verona, Verona, Italy.

PURPOSE: One of the major concerns among surgeons is the hypothetical risk that after administration of lipoaspirate to treat functional and cosmetic sequelae following breast conservative treatment(BCT), patients could develop calcifications that might be confused with the micro calcifications associated with breast malignancies. The purpose of this study is to evaluate this hypothetical risk.
METHOD:Forty patients without suspicious calcifications on their mammogram after BCT were enrolled in the study.The first twenty consecutive patients who:1)underwent BCT for cancer;2) were treated with lipoaspirate transplant to correct the BCT functional-cosmetic sequelae;3) had one mammogram every year always performed in the same XY Hospital,were assigned to the treatment group.The median time since the BCT in this group of patients resulted of seven years.The .treatment with lipoaspirate was performed between 2001 and 2004.An average of 3.7 treatment was performed per case depending on the amount of radiation damage and the cosmetic defect.The first twenty consecutive patients after BCT,selected from the database of the XY Regional Oncological Departement with:1)a median follow-up of 7 years;2)one mammogram every year performed in the same XY Hospital;3)no treatment with lipoaspirate, were included in the control group.All mammograms both of treated and control group were reanalyzed in October 2007 by a single radiologist and confirmed by a second radiologist.
RESULTS:Treatment group:16 patients demonstrated unchanged mammograms,2 patients demonstrated calcified steatonecrotic areas and 2 patients demonstrated a single calcification not previously detected.Calcified steatonecrosis and calcifications appeared in different times with no statistical significance.In all cases the calcifications seen were completely different from the micro calcifications associated with breast malignancies. Control group:12 patients demonstrated unchanged mammograms.4 patients developed calcifications that were not suspicious for cancer,2 patients developed calcified steatonecrotic areas,1 patient demonstrated an oil cyst and 1 patient demonstrated a micro calcification that was suspicious and which was confirmed as a cancer after biopsy.
CONCLUSION: In this study, therapy with lipoaspirate transplant to correct the side effects of BCT,does not increase the risk of suspicious calcifications in the breast.On the contrary it may even reduce the normal increased tendency of irradiated tissues to generate calcifications. An explanation could be the following:there are evidences that Adipose-derived-Mesenchimal-Stem-cells(AMSCs) exhibit multilineage potential being able to create different tissues like vessels,bone,fat¼.Recent studies demonstrated the AMSCs clinical effectiveness in irradiated tissues when:1)not expanded;2)maintained in their natural 3D scaffold;3)transplanted together with the surrounding centrifuged lipoaspirate.This treatment transforms irradiated tissues into normal tissues with consequent lower tendency to generate calcifications.


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