Lipomodeling the breast: will fat grafting impact your mammogram?
Lipomodeling (aka fat grafting) is a relatively new approach to breast augmentation in which fat is removed from another area of the body (liposuction) and transferred to the breasts. A recent study (Veber, et al. Plas Recon Surg Vol 127, No 3, Mar 2011, p1289) has shown that this procedure does not interfere with routine screening mammograms. This is in direct contrast to another recent , similar study. However, the results of this study are not as clear as they may seem; so take caution. This study was designed to specifically assess the radiographic findings (on mammogram) that can occur after breast augmentation using autologous fat transfer, and to determine if fat grafting created any problems with routine mammogram screening for breast cancer.
There are several important issues to discuss with this study:
1) Post-fat grafting mammogram radiographic signs (i.e. abnormalities) were visible in <50%.
2) Overall breast density remained stable. Breast density is defined by the ratio of mammary gland tissue to the surrounding fat. Increased breast density is associated with a lower sensitivity of mammography. Further, high breast density is a major risk factor for breast cancer.
3) Radiographic follow-up was not more difficult after fat grafting.
4) A significant portion of the cases were fat grafting cases performed in combination with a mastopexy. In my mind, this confounds the issue. Further, the volume of fat injected was much lower than the average volume of an implant augmentation. Therefore it is unclear if the data can be extrapolated to higher volume fat augmentation cases; in which case one would expect a higher percentage of abnormalities on mammography.
This study is only preliminary, but it provides important information for health care professionals performing mammograms in women who have undergone this new approach to breast augmentation. The authors suggest that women undergoing lipomodeling have a complete evaluation including mammograms and ultrasounds both before and soon after the procedure to provide a new baseline. This will provide reassurance that any new abnormalities noted are a result of the lipomodeling procedure. This will hopefully reduce the suspicion and need for investigation of potential breast cancers in this patient population..