For the first time, doctors have used stem cells from liposuctioned fat to fix breast defects in women who have had cancerous lumps removed.
The approach is still experimental, but holds promise for millions of women left with cratered areas and breasts that look very different from each other after cancer surgery. It also might be a way to augment healthy breasts without using artificial implants.
So far, it has only been tested on about two dozen women in a study in Japan. But doctors in the US say it has great potential.
"This is a pretty exciting topic right now in plastic surgery," said Karol Gutowski at the University of Wisconsin-Madison. "There are people all over the country working on this."
The Japanese study was reported on Saturday at the San Antonio Breast Cancer Symposium. The company that developed the treatment, Cytori Therapeutics, plans larger studies in Europe and Japan next year.
More than 100,000 women have lumps removed each year in the US. These operations, lumpectomies, often are done instead of mastectomies, which take the whole breast. But they often leave deformities because as much as a third of a woman's breast may be removed.
The defect "initially may not be as noticeable" but it often gets worse, especially if the woman also has radiation treatment, said Sameer Patel, a reconstructive surgeon at Fox Chase Cancer Center in Philadelphia.
The implants sold today are for reconstructing breasts after mastectomies. They aren't designed to fix odd-shaped deformities from lumpectomies or radiation.
"Each one is so different, there's no little thing you can just pop in there," Gutowski said.
Doctors can try making the other breast smaller so they match, transplanting a back muscle to boost the flawed breast, or rearranging tissue to more evenly distribute what's left. But these involve surgery and leave scars.
Mini implants of fat tissue have been tried, but they often get resorbed by the body or die and turn hard and lumpy. The recent discovery that fat cells are rich in stem cells -- master cells that can replenish themselves and form other tissues in the body -- renewed interest in their use.
In the Japanese study, doctors liposuctioned fat from 21 cancer patients' bellies, hips or thighs. Half was reserved as the main implant material; the rest was processed to extract stem cells and combined with the reserved fat. This was injected in three places around a breast defect.
Doctors think the stem cells will keep the tissue from dying and form lasting mini implants.
Eight months after treatment, "about 80 percent of the patients are satisfied" with the results, said the lead researcher, Keizo Sugimachi at Kyushu University in Fukuoka, Japan.
There was a statistically significant improvement in breast tissue thickness at one and six months after treatment.
The treatment is expected to cost US$3,000 to US$5,000, said Cytori's president, Mark Hedrick.
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