Superior Sensibility after Full Breast Reconstruction with Autologous Fat Transfer

Abstract

Background: With developments in screening and treatment, survival rates of breast cancer patients are increasing, and so is the number of women opting for breast reconstruction to improve their quality of life. One factor that could play an important role in improving the quality of life is breast sensibility. Therefore, the aim of this study was to explore breast sensibility in participants of the Breast Reconstruction with External Preexpansion and Autologous Fat Transfer versus Standard Therapy trial: an ongoing randomized controlled trial comparing breast reconstruction with autologous fat transfer (AFT) versus implant-based reconstruction (IBR).

Methods: This study was conducted on participants of the Breast Reconstruction with External Preexpansion and Autologous Fat Transfer versus Standard Therapy trial who were at least 12 months after final surgery. Semmes-Weinstein monofilaments were used to measure skin sensibility in breast cancer patients who underwent breast reconstruction with either AFT or IBR following their mastectomy.

Results: A total of 46 patients were included in this study, resulting in 62 breast reconstructions (28 AFT breasts and 34 IBR breasts). Significantly higher mean monofilament values were found for skin sensibility after AFT (-0.7; P < 0.001), clinically correlating to "diminished protective function," as opposed to the IBR group, with clinical values indicating "loss of protective function."

Conclusions: In this study, the authors found that breast cancer patients who underwent a mastectomy had a significantly better sensibility of the breast following AFT for total breast reconstruction as compared with IBR. Larger studies that include null measurements are required to further explore these noteworthy results of AFT.

Clinical question/level of evidence: Therapeutic, II.

Trial registration: ClinicalTrials.gov NCT02339779.

Fig. 1.

Predefined measurement areas of the breast and example of SWM testing. (Copyright © 2022 Ava Krueger, scientific illustrator.)

Fig. 2.

Interpretive illustration showing altered level of sensibility following AFT (right) and IBR (left). The index shows the definition of the colors, with red indicating loss of protective function. In this figure, we show the sensibility in the breast returns to diminished protective function following AFT reconstruction, whereas a larger area surrounding mamilla in IBR patients shows a loss of protective function. (Copyright © 2022 Ava Krueger, scientific illustrator.)