Breast Neoplasms Clinical Trial
Official title:
Does Pre-treatment With Autologous Fat Transplantation Improve Results and Reduce Complication Rate After Breast Reconstruction With Implants? A Randomized Controlled Study
The purpose of this study is to determine if autologous fat transplantation as a
pre-treatment gives better results in breast reconstruction with implants after mastectomy
and radiotherapy. One group is randomized to conventional reconstruction with implant and one
to pre-treatment prior reconstruction with implant.
Our aims are:
1. To study whether lipofilling can decrease the number of reoperations and complications
such as postoperative infections or not.
2. Evaluate the aesthetic results and the patients' experiences. For both these aims the
hypothesis is that pre-treatment is in favour for the outcomes.
All patients will undergo breast reconstruction with expander implant. Half of the patients
will be randomized to pre-treatment with lipofilling before the reconstruction. The
randomization will be carried out with block randomization. A certain person that has not met
the patients has been assigned to do this.
Fat transplantation: The fat will be harvested manually with dry technique using a Coleman
cannula on a 10 ml syringe. There after the syringes and fat are centrifuged at 3000 rpm for
3 minutes. Liquid fat from lysed cells and blood will be separated from the purified fat
cells and discarded. The fat graft will then be injected fan-shaped in multiple layers into
the subcutaneous tissues of the breast using another blunt cannula with a diameter of 1.29
mm. If necessary to obtain a volume of 100 ml fat injected the procedure will be repeated.
All sessions will be performed under general anesthesia in day surgery. Three month later the
patients will undergo breast reconstruction with expander prosthesis.
Those patients that are randomized to not undergo pre-treatment will undergo breast
reconstruction with expander prosthesis immediately.
After the reconstruction all patients will have as many appointments as necessary for
expansion with a breast nurse at our clinic. If necessary the patient will also meet the
surgeon. After the month the patients have a routine doctors appointment. After 6, 12 and 24
month the patients will be followed up with objective measurements of breast symmetry and
they will fill in quality of life formularies. In this study we are using the validated
formulary called Breast Q and a study specific formulary. At 24 month standardized photos of
the breasts will be taken.
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