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Kijima Y, Koriyama C, Fujii T, Hirokaga K, Ishigure K, Kaneko T, Kayano S, Miyamoto S, Sagara Y, Sakurai T, Sakurai T, Sotome K, Ueo H, Wakita K, Watatani M. Immediate breast volume replacement using a free dermal fat graft after breast cancer surgery: multi-institutional joint research of short-term outcomes in 262 Japanese patients. Gland Surg 2015; 4:179-94. [PMID: 26005649 DOI: 10.3978/j.issn.2227-684x.2015.01.06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 01/05/2015] [Indexed: 11/14/2022]
Abstract
BACKGROUND Immediate volume replacement using a free dermal fat graft (FDFG) has been proven safe with early postoperative benefits. The aims of the present study were to clarify adequate indications and risk factors associated with operative morbidity. PATIENTS AND METHODS A multi-institutional analysis of partial mastectomy with immediate volume replacement with FDFG was undertaken in 14 hospitals specializing in breast cancer treatment. Clinical and oncological variables were analyzed to identify factors associated with postoperative complications. RESULTS A total of 262 cases were analyzed. Considering the observation period and overlap of patients, 13 (5.4%) out of 242 patients had complications within 1 month of surgery while 7 (4.6%) out of 151 patients developed complications 1-12 months after surgery. Two hundred and eleven out of 242 patients were statistically examined using a multivariate analysis, which revealed that the weight of resected breast tissue, size of implanted FDFG (cranio-caudal length), and weight of implanted FDFG were associated with a higher likelihood of postoperative complications. CONCLUSIONS Immediate breast volume replacement using a FDFG after breast cancer surgery should be done for selected patients with breast cancer to avoid postoperative complications. The prospective and larger investigations are warranted for the establishment of appropriate guidelines.
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Affiliation(s)
- Yuko Kijima
- 1 Department of Digestive Surgery, Breast and Thyroid Surgery, 2 Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan ; 3 Breast Care Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan ; 4 Department of Breast Oncology, Hyogo Cancer Center, Hyogo, Japan ; 5 Department of Surgery, Konan Kosei Hospital, Aichi, Japan ; 6 Kaneko Clinic, Kagoshima, Japan ; 7 Plastic and Reconstructive Surgery Department, National Cancer Center Hospital, Tokyo, Japan ; 8 Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan ; 9 Department of Breast Surgery, Sagara Hospital, Kagoshima, Japan ; 10 Division of Surgery, Saitama Social Insurance Hospital, Saitama, Japan ; 11 Department of Surgery, Wakayama Medical University, Kihoku Hospital, Wakayama, Japan ; 12 Department of Surgery, Fussa Hospital, Tokyo, Japan ; 13 Ueo Breast Cancer Hospital, Oita, Japan ; 14 Chayamachi Breast Clinic, Osaka, Japan ; 15 Department of Breast Surgery, Kinki University Faculty of Medicine, Nara Hospital, Osaka, Japan
| | - Chihaya Koriyama
- 1 Department of Digestive Surgery, Breast and Thyroid Surgery, 2 Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan ; 3 Breast Care Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan ; 4 Department of Breast Oncology, Hyogo Cancer Center, Hyogo, Japan ; 5 Department of Surgery, Konan Kosei Hospital, Aichi, Japan ; 6 Kaneko Clinic, Kagoshima, Japan ; 7 Plastic and Reconstructive Surgery Department, National Cancer Center Hospital, Tokyo, Japan ; 8 Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan ; 9 Department of Breast Surgery, Sagara Hospital, Kagoshima, Japan ; 10 Division of Surgery, Saitama Social Insurance Hospital, Saitama, Japan ; 11 Department of Surgery, Wakayama Medical University, Kihoku Hospital, Wakayama, Japan ; 12 Department of Surgery, Fussa Hospital, Tokyo, Japan ; 13 Ueo Breast Cancer Hospital, Oita, Japan ; 14 Chayamachi Breast Clinic, Osaka, Japan ; 15 Department of Breast Surgery, Kinki University Faculty of Medicine, Nara Hospital, Osaka, Japan
| | - Teruhiko Fujii
- 1 Department of Digestive Surgery, Breast and Thyroid Surgery, 2 Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan ; 3 Breast Care Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan ; 4 Department of Breast Oncology, Hyogo Cancer Center, Hyogo, Japan ; 5 Department of Surgery, Konan Kosei Hospital, Aichi, Japan ; 6 Kaneko Clinic, Kagoshima, Japan ; 7 Plastic and Reconstructive Surgery Department, National Cancer Center Hospital, Tokyo, Japan ; 8 Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan ; 9 Department of Breast Surgery, Sagara Hospital, Kagoshima, Japan ; 10 Division of Surgery, Saitama Social Insurance Hospital, Saitama, Japan ; 11 Department of Surgery, Wakayama Medical University, Kihoku Hospital, Wakayama, Japan ; 12 Department of Surgery, Fussa Hospital, Tokyo, Japan ; 13 Ueo Breast Cancer Hospital, Oita, Japan ; 14 Chayamachi Breast Clinic, Osaka, Japan ; 15 Department of Breast Surgery, Kinki University Faculty of Medicine, Nara Hospital, Osaka, Japan
| | - Kouichi Hirokaga
- 1 Department of Digestive Surgery, Breast and Thyroid Surgery, 2 Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan ; 3 Breast Care Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan ; 4 Department of Breast Oncology, Hyogo Cancer Center, Hyogo, Japan ; 5 Department of Surgery, Konan Kosei Hospital, Aichi, Japan ; 6 Kaneko Clinic, Kagoshima, Japan ; 7 Plastic and Reconstructive Surgery Department, National Cancer Center Hospital, Tokyo, Japan ; 8 Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan ; 9 Department of Breast Surgery, Sagara Hospital, Kagoshima, Japan ; 10 Division of Surgery, Saitama Social Insurance Hospital, Saitama, Japan ; 11 Department of Surgery, Wakayama Medical University, Kihoku Hospital, Wakayama, Japan ; 12 Department of Surgery, Fussa Hospital, Tokyo, Japan ; 13 Ueo Breast Cancer Hospital, Oita, Japan ; 14 Chayamachi Breast Clinic, Osaka, Japan ; 15 Department of Breast Surgery, Kinki University Faculty of Medicine, Nara Hospital, Osaka, Japan
| | - Kiyoshi Ishigure
- 1 Department of Digestive Surgery, Breast and Thyroid Surgery, 2 Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan ; 3 Breast Care Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan ; 4 Department of Breast Oncology, Hyogo Cancer Center, Hyogo, Japan ; 5 Department of Surgery, Konan Kosei Hospital, Aichi, Japan ; 6 Kaneko Clinic, Kagoshima, Japan ; 7 Plastic and Reconstructive Surgery Department, National Cancer Center Hospital, Tokyo, Japan ; 8 Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan ; 9 Department of Breast Surgery, Sagara Hospital, Kagoshima, Japan ; 10 Division of Surgery, Saitama Social Insurance Hospital, Saitama, Japan ; 11 Department of Surgery, Wakayama Medical University, Kihoku Hospital, Wakayama, Japan ; 12 Department of Surgery, Fussa Hospital, Tokyo, Japan ; 13 Ueo Breast Cancer Hospital, Oita, Japan ; 14 Chayamachi Breast Clinic, Osaka, Japan ; 15 Department of Breast Surgery, Kinki University Faculty of Medicine, Nara Hospital, Osaka, Japan
| | - Tomoyo Kaneko
- 1 Department of Digestive Surgery, Breast and Thyroid Surgery, 2 Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan ; 3 Breast Care Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan ; 4 Department of Breast Oncology, Hyogo Cancer Center, Hyogo, Japan ; 5 Department of Surgery, Konan Kosei Hospital, Aichi, Japan ; 6 Kaneko Clinic, Kagoshima, Japan ; 7 Plastic and Reconstructive Surgery Department, National Cancer Center Hospital, Tokyo, Japan ; 8 Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan ; 9 Department of Breast Surgery, Sagara Hospital, Kagoshima, Japan ; 10 Division of Surgery, Saitama Social Insurance Hospital, Saitama, Japan ; 11 Department of Surgery, Wakayama Medical University, Kihoku Hospital, Wakayama, Japan ; 12 Department of Surgery, Fussa Hospital, Tokyo, Japan ; 13 Ueo Breast Cancer Hospital, Oita, Japan ; 14 Chayamachi Breast Clinic, Osaka, Japan ; 15 Department of Breast Surgery, Kinki University Faculty of Medicine, Nara Hospital, Osaka, Japan
| | - Shuji Kayano
- 1 Department of Digestive Surgery, Breast and Thyroid Surgery, 2 Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan ; 3 Breast Care Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan ; 4 Department of Breast Oncology, Hyogo Cancer Center, Hyogo, Japan ; 5 Department of Surgery, Konan Kosei Hospital, Aichi, Japan ; 6 Kaneko Clinic, Kagoshima, Japan ; 7 Plastic and Reconstructive Surgery Department, National Cancer Center Hospital, Tokyo, Japan ; 8 Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan ; 9 Department of Breast Surgery, Sagara Hospital, Kagoshima, Japan ; 10 Division of Surgery, Saitama Social Insurance Hospital, Saitama, Japan ; 11 Department of Surgery, Wakayama Medical University, Kihoku Hospital, Wakayama, Japan ; 12 Department of Surgery, Fussa Hospital, Tokyo, Japan ; 13 Ueo Breast Cancer Hospital, Oita, Japan ; 14 Chayamachi Breast Clinic, Osaka, Japan ; 15 Department of Breast Surgery, Kinki University Faculty of Medicine, Nara Hospital, Osaka, Japan
| | - Sachio Miyamoto
- 1 Department of Digestive Surgery, Breast and Thyroid Surgery, 2 Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan ; 3 Breast Care Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan ; 4 Department of Breast Oncology, Hyogo Cancer Center, Hyogo, Japan ; 5 Department of Surgery, Konan Kosei Hospital, Aichi, Japan ; 6 Kaneko Clinic, Kagoshima, Japan ; 7 Plastic and Reconstructive Surgery Department, National Cancer Center Hospital, Tokyo, Japan ; 8 Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan ; 9 Department of Breast Surgery, Sagara Hospital, Kagoshima, Japan ; 10 Division of Surgery, Saitama Social Insurance Hospital, Saitama, Japan ; 11 Department of Surgery, Wakayama Medical University, Kihoku Hospital, Wakayama, Japan ; 12 Department of Surgery, Fussa Hospital, Tokyo, Japan ; 13 Ueo Breast Cancer Hospital, Oita, Japan ; 14 Chayamachi Breast Clinic, Osaka, Japan ; 15 Department of Breast Surgery, Kinki University Faculty of Medicine, Nara Hospital, Osaka, Japan
| | - Yasuaki Sagara
- 1 Department of Digestive Surgery, Breast and Thyroid Surgery, 2 Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan ; 3 Breast Care Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan ; 4 Department of Breast Oncology, Hyogo Cancer Center, Hyogo, Japan ; 5 Department of Surgery, Konan Kosei Hospital, Aichi, Japan ; 6 Kaneko Clinic, Kagoshima, Japan ; 7 Plastic and Reconstructive Surgery Department, National Cancer Center Hospital, Tokyo, Japan ; 8 Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan ; 9 Department of Breast Surgery, Sagara Hospital, Kagoshima, Japan ; 10 Division of Surgery, Saitama Social Insurance Hospital, Saitama, Japan ; 11 Department of Surgery, Wakayama Medical University, Kihoku Hospital, Wakayama, Japan ; 12 Department of Surgery, Fussa Hospital, Tokyo, Japan ; 13 Ueo Breast Cancer Hospital, Oita, Japan ; 14 Chayamachi Breast Clinic, Osaka, Japan ; 15 Department of Breast Surgery, Kinki University Faculty of Medicine, Nara Hospital, Osaka, Japan
| | - Takashi Sakurai
- 1 Department of Digestive Surgery, Breast and Thyroid Surgery, 2 Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan ; 3 Breast Care Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan ; 4 Department of Breast Oncology, Hyogo Cancer Center, Hyogo, Japan ; 5 Department of Surgery, Konan Kosei Hospital, Aichi, Japan ; 6 Kaneko Clinic, Kagoshima, Japan ; 7 Plastic and Reconstructive Surgery Department, National Cancer Center Hospital, Tokyo, Japan ; 8 Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan ; 9 Department of Breast Surgery, Sagara Hospital, Kagoshima, Japan ; 10 Division of Surgery, Saitama Social Insurance Hospital, Saitama, Japan ; 11 Department of Surgery, Wakayama Medical University, Kihoku Hospital, Wakayama, Japan ; 12 Department of Surgery, Fussa Hospital, Tokyo, Japan ; 13 Ueo Breast Cancer Hospital, Oita, Japan ; 14 Chayamachi Breast Clinic, Osaka, Japan ; 15 Department of Breast Surgery, Kinki University Faculty of Medicine, Nara Hospital, Osaka, Japan
| | - Teruhisa Sakurai
- 1 Department of Digestive Surgery, Breast and Thyroid Surgery, 2 Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan ; 3 Breast Care Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan ; 4 Department of Breast Oncology, Hyogo Cancer Center, Hyogo, Japan ; 5 Department of Surgery, Konan Kosei Hospital, Aichi, Japan ; 6 Kaneko Clinic, Kagoshima, Japan ; 7 Plastic and Reconstructive Surgery Department, National Cancer Center Hospital, Tokyo, Japan ; 8 Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan ; 9 Department of Breast Surgery, Sagara Hospital, Kagoshima, Japan ; 10 Division of Surgery, Saitama Social Insurance Hospital, Saitama, Japan ; 11 Department of Surgery, Wakayama Medical University, Kihoku Hospital, Wakayama, Japan ; 12 Department of Surgery, Fussa Hospital, Tokyo, Japan ; 13 Ueo Breast Cancer Hospital, Oita, Japan ; 14 Chayamachi Breast Clinic, Osaka, Japan ; 15 Department of Breast Surgery, Kinki University Faculty of Medicine, Nara Hospital, Osaka, Japan
| | - Keiichi Sotome
- 1 Department of Digestive Surgery, Breast and Thyroid Surgery, 2 Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan ; 3 Breast Care Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan ; 4 Department of Breast Oncology, Hyogo Cancer Center, Hyogo, Japan ; 5 Department of Surgery, Konan Kosei Hospital, Aichi, Japan ; 6 Kaneko Clinic, Kagoshima, Japan ; 7 Plastic and Reconstructive Surgery Department, National Cancer Center Hospital, Tokyo, Japan ; 8 Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan ; 9 Department of Breast Surgery, Sagara Hospital, Kagoshima, Japan ; 10 Division of Surgery, Saitama Social Insurance Hospital, Saitama, Japan ; 11 Department of Surgery, Wakayama Medical University, Kihoku Hospital, Wakayama, Japan ; 12 Department of Surgery, Fussa Hospital, Tokyo, Japan ; 13 Ueo Breast Cancer Hospital, Oita, Japan ; 14 Chayamachi Breast Clinic, Osaka, Japan ; 15 Department of Breast Surgery, Kinki University Faculty of Medicine, Nara Hospital, Osaka, Japan
| | - Hiroaki Ueo
- 1 Department of Digestive Surgery, Breast and Thyroid Surgery, 2 Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan ; 3 Breast Care Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan ; 4 Department of Breast Oncology, Hyogo Cancer Center, Hyogo, Japan ; 5 Department of Surgery, Konan Kosei Hospital, Aichi, Japan ; 6 Kaneko Clinic, Kagoshima, Japan ; 7 Plastic and Reconstructive Surgery Department, National Cancer Center Hospital, Tokyo, Japan ; 8 Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan ; 9 Department of Breast Surgery, Sagara Hospital, Kagoshima, Japan ; 10 Division of Surgery, Saitama Social Insurance Hospital, Saitama, Japan ; 11 Department of Surgery, Wakayama Medical University, Kihoku Hospital, Wakayama, Japan ; 12 Department of Surgery, Fussa Hospital, Tokyo, Japan ; 13 Ueo Breast Cancer Hospital, Oita, Japan ; 14 Chayamachi Breast Clinic, Osaka, Japan ; 15 Department of Breast Surgery, Kinki University Faculty of Medicine, Nara Hospital, Osaka, Japan
| | - Kazuyuki Wakita
- 1 Department of Digestive Surgery, Breast and Thyroid Surgery, 2 Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan ; 3 Breast Care Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan ; 4 Department of Breast Oncology, Hyogo Cancer Center, Hyogo, Japan ; 5 Department of Surgery, Konan Kosei Hospital, Aichi, Japan ; 6 Kaneko Clinic, Kagoshima, Japan ; 7 Plastic and Reconstructive Surgery Department, National Cancer Center Hospital, Tokyo, Japan ; 8 Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan ; 9 Department of Breast Surgery, Sagara Hospital, Kagoshima, Japan ; 10 Division of Surgery, Saitama Social Insurance Hospital, Saitama, Japan ; 11 Department of Surgery, Wakayama Medical University, Kihoku Hospital, Wakayama, Japan ; 12 Department of Surgery, Fussa Hospital, Tokyo, Japan ; 13 Ueo Breast Cancer Hospital, Oita, Japan ; 14 Chayamachi Breast Clinic, Osaka, Japan ; 15 Department of Breast Surgery, Kinki University Faculty of Medicine, Nara Hospital, Osaka, Japan
| | - Masahiro Watatani
- 1 Department of Digestive Surgery, Breast and Thyroid Surgery, 2 Department of Epidemiology and Preventive Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan ; 3 Breast Care Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan ; 4 Department of Breast Oncology, Hyogo Cancer Center, Hyogo, Japan ; 5 Department of Surgery, Konan Kosei Hospital, Aichi, Japan ; 6 Kaneko Clinic, Kagoshima, Japan ; 7 Plastic and Reconstructive Surgery Department, National Cancer Center Hospital, Tokyo, Japan ; 8 Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan ; 9 Department of Breast Surgery, Sagara Hospital, Kagoshima, Japan ; 10 Division of Surgery, Saitama Social Insurance Hospital, Saitama, Japan ; 11 Department of Surgery, Wakayama Medical University, Kihoku Hospital, Wakayama, Japan ; 12 Department of Surgery, Fussa Hospital, Tokyo, Japan ; 13 Ueo Breast Cancer Hospital, Oita, Japan ; 14 Chayamachi Breast Clinic, Osaka, Japan ; 15 Department of Breast Surgery, Kinki University Faculty of Medicine, Nara Hospital, Osaka, Japan
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