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Importance Autologous fat grafting (AFG), or lipofilling, has been used for immediate reconstruction at the time of breast-conserving surgery in order to achieve a satisfactory cosmetic outcome in patients with breast cancer and an unfavorable tumor-to-breast volume ratio or unfavorable tumor location. However, the oncologic safety of this technique is still unclear. Objective To determine whether AFG performed simultaneously with breast-conserving surgery is associated with differences in local relapse rates and disease-free survival. Design Matched retrospective cohort study. Setting Tertiary referral center. Participants Patients undergoing breast-conserving surgery with or without AFG between 2004 and 2016 were retrospectively enrolled and matched for age, staging, grade, tumor histology, and tumor immunohistochemical profile. Main outcome(s) and measure(s) The cumulative incidence of locoregional recurrence (LRR) and disease-free survival were the primary end points, while distant recurrence and overall survival were the secondary end points. Results A total of 320 patients were followed. Cases were matched with controls at a 1:4 ratio. There was no difference in LRR or distant recurrence of breast cancer between the two groups. The annual LRR rate was 0.86% in patients who received immediate AFG vs. 0.7% in patients undergoing breast-conserving surgery alone ( p  ≥ 0.05). Number of lymph nodes was the sole independent risk factor for local recurrence ( p  = 0.045). No significant differences in disease-free survival rates were found between the groups. Conclusions and relevance At a mean follow-up of 5 years, no significant differences in locoregional recurrence rates were found between patients who received immediate AFG and those who underwent breast-conserving surgery alone. These findings corroborate previous research demonstrating the oncological safety of immediate AFG reconstruction, further suggesting that this technique as a safe, effective way to achieve optimal cosmetic outcomes in primary breast cancer surgery without jeopardizing oncologic outcomes.

Breast cancer is a condition characterized by the uncontrolled growth of breast cancer cells. The treatment for the disease, such as surgery, chemotherapy, radiotherapy, and systemic therapy, can significantly impact patients’ body image and overall quality of life. This study aimed to evaluate body image perceptions and cancer-related quality of life in women who underwent surgical treatment for breast cancer at a reference hospital in southern Brazil. One hundred six women with breast cancer, aged 21 to 93 years (M = 55.3; SD = 12.9), participated in this cross-sectional study. They responded to the Body Image and Relationships Scale (BIRS), Functional Assessment of Cancer Therapy for Breast Cancer scale (FACT-B), and a questionnaire on clinical and sociodemographic variables. Multiple linear regression analyses revealed that general perceived body image, as measured by BIRS, was significantly predicted by younger age and chemotherapy (F(2, 99) = 7.376, p = 0.003). These predictors accounted for 11.2% of the variance in BIRS (adjusted R2 = 0.112). Hierarchical multiple regression analysis indicated that cancer-related quality of life was significantly predicted by younger age, use of psychiatric medication, and body image domains, including strength and health, social barriers, and appearance and sexuality. The complete model, encompassing all predictors, was significant (F(5, 96) = 15.970, p < 0.001) and explained 42.6% of the variance in FACT-B (adjusted R2 = 0.426). Clinicians should be aware that younger patients who have undergone chemotherapy for breast cancer may experience changes in body image perception following surgery. Contributing factors such as younger age, use of psychiatric medications, and negative postoperative body image may be associated with a diminished quality of life related to cancer.

Background This study evaluated the predictive value of tumor-infiltrating lymphocytes (TILs) in residual triple-negative breast cancer (TNBC) following neoadjuvant chemotherapy (NAC). Patients and methods Patients with TNBC treated between 2008 and 2019 who presented with residual disease after NAC were included. Tumor samples were assessed before and after treatment, with TILs quantified as the percentage of mononuclear inflammatory cells in the tumor stroma. TILs levels were analyzed as both continuous and categorical variables (high ≥ 30%, low < 30%). Among the 60 patients evaluated, the mean age was 52.6 ± 1.2 years (range: 28–78 years), with most receiving standard NAC, consisting of anthracycline and cyclophosphamide followed by docetaxel. Results A significant increase in TILs levels post-NAC was observed, with 55% of tumors classified as high TILs, compared to 90% classified as low TILs before treatment (McNemar’s test, p  ≤ 0.0001). However, post-NAC TILs increase was not statistically associated with disease-free survival or overall survival. Conclusion These findings suggest an immunologic modulation of the tumor microenvironment in residual TNBC, highlighting the potential role of identifying immune-enriched residual tumors as candidates for adjuvant strategies, including immunotherapy.