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Published: 2019-03-26 09:14 | Updated: 2019-03-26 09:15

Autologous fat transfer can reduce radiation-induced fibrosis in breast cancer patients

New study provides some biological support for autologous fat transfer as a surgical method that can reduce radiation-induced fibrosis in patients going through breast cancer. This has been demonstrated by researchers in Reconstructive Plastic Surgery and Breast Surgery groups, the Department of Molecular Medicine and Surgery in a recent study published in the British Journal of Surgery.

Anna Lindegren och Martin Halle

Damage to normal tissue is still the most limiting factor for radiation therapy during cancer treatment. In a growing group of cancer survivors, radiation therapy increases the risk of surgical complications and can also lead to both cosmetic and functional impairment. The existing knowledge of the underlying pathology is incomplete and there is no given therapy for this tissue transformation, so-called fibrosis. Clinical symptoms usually appear many years after treatment, which makes experimental studies difficult.

By comparing irradiated and non-irradiated fat tissue from the breasts of patients with previous unilateral breast cancer, we have been able to study gene expression patterns linked to late radiation damage. Furthermore, we have transferred abdominal fat tissue from the patient´s abdomen to the irradiated breast and again harvested biopsies from each breast one year after surgery. Using microarray technology, we have been able to study which type of gene expression and which signalling pathways are affected by radiation therapy, but also how the autologous transfer of fat tissue can affect these signalling pathways. The results show that gene expression related to radiation-induced chronic inflammation and tissue hypoxia is affected by autologous fat transfer.

”In this way, the study provides us with some biological support that autologous fat transfer is a surgical method that can reduce radiation-induced fibrosis in patients with previous breast cancer,” says Martin Halle, Senior Consultant at Karolinska University Hospital and Principal Investigator for the current study with the groups, Reconstructive Plastic Surgery and Breast Surgery at the Department of Molecular Medicine and Surgery that has led the study. The study has received a lot of positive attention, including the prize for best lecture by the Swedish Plastic Surgery Association and was also named presentation of the year by the European Association of Plastic Surgeons (EURAPS).

Other researchers at the Department of Molecular Medicine and Surgery who have contributed to the study in addition to Martin Halle, are first author Anna Lindegren, Marie Wickman, primary supervisor for defence of doctoral thesis for Anna Lindegren, as well as Inkeri Schultz and Michael Tekle, who along with Martin Halle has been secondary co-supervisor for Anna Lindegren.

Publication

Autologous fat transplantation alters gene expression patterns related to inflammation and hypoxia in the irradiated human breast.
Lindegren A, Schultz I, Sinha I, Cheung L, Khan A, Tekle M, et al
Br J Surg 2019 Apr;106(5):563-573