20 december 2022 – 07:16
Complete breast reconstruction with your own fat tissue is effective, safe and reimbursed from 1 January 2023
Research has shown that it is safe to completely reconstruct an amputated breast with one’s own fat tissue. Moreover, patients who opted for this new treatment ultimately have a better quality of life than with other forms of breast reconstruction. Breast reconstruction with your own fat tissue will be reimbursed by health insurers from 1 January 2023, subject to certain conditions.
In recent years, a team led by Maastricht UMC + has investigated this treatment in a large-scale study called BREAST Trial I & II. In recent years, the researchers have published about this research in various scientific journals.
Breast reconstruction
For some women with breast cancer, removal of an entire breast is the best treatment. It also happens that women have their breasts removed preventively, because as carriers of a certain gene they have an increased risk of breast cancer. Up to now there have been two methods for reconstructing the removed breast. Firstly, placing an implant, or silicone prosthesis. But this method is not suitable in all cases. Second, there is a breast reconstruction method with a free flap, such as the so-called DIEP flap. For this, skin and fat tissue is removed from the abdomen and replaced in the place of the chest. This method has the disadvantage that the operation takes about six to eight hours and leaves a permanent scar on the abdomen.
Own fat tissue
The currently available breast reconstruction methods have major drawbacks, as a result of which some patients are unwilling or unable to undergo breast reconstruction. That is why Maastricht UMC+ led the research into a new third method: lipofilling, or the use of your own fat tissue. With this treatment, the plastic surgeon removes fat from, for example, the hip, thighs or abdomen and injects these fats into the chest. Lipofilling is already used to fill imperfections after a previous reconstruction or for partial (breast) reconstructions, but it has not yet been shown to be safe and effective for a full breast reconstruction.
Comparison
The researchers compared 91 patients who underwent reconstruction with their own adipose tissue with 80 patients who received an implant. The first group had a significantly higher quality of life after the operation, because they were more satisfied with their breasts, their physical well-being and the outcomes of the treatment. There were also no indications that reconstruction with your own fat tissue is unsafe.
Compensation
Research leader and plastic surgeon Andrzej Piatkowski is enthusiastic about the treatment and research results: ‘For many patients, good breast reconstruction after breast cancer treatment is invaluable. It is essential for self-confidence and quality of life. But it is clear that current methods are not suitable for every patient for various reasons. That is why it is a big step forward for breast cancer patients that we can offer this full breast reconstruction with our own adipose tissue to a large group as an option reimbursed by health insurance. ‘
Reimbursed from 1 January 2023
On 19 December, the National Health Care Institute announced that breast reconstruction with your own fat tissue will be reimbursed from 1 January, subject to certain conditions. These conditions for the appropriate provision of this care are set out in a ‘guarantee document’, which has been drawn up with the professional group of plastic surgeons, patient representatives and health insurers. An important criterion for receiving the treatment is that the patient is not undergoing or has not undergone radiotherapy.
Collaboration
The research is a long-standing collaboration between various centers: Alexander Monro Hospital, Rijnstate, Medical Center Leeuwarden, East Netherlands Breast Clinic, Amsterdam UMC, Amphia Hospital, VieCuri Medical Center and Maastricht UMC+. As the largest center for breast reconstruction in the Netherlands, Maastricht UMC+ is the coordinator of the research.
Source: Maastricht UMC+
Editorial Medicalfacts/ Janine Budding
I studied physiotherapy and Health Care business administration. I am also a registered independent client support worker and informal care broker. I have a lot of experience in various positions in healthcare, the social domain and the medical, pharmaceutical industry, nationally and internationally. And have broad medical knowledge of most healthcare specialties. And of the care laws from which the care is regulated and financed. Every year I attend most of the leading medical conferences in Europe and America to keep my knowledge up-to-date and to keep up with the latest developments and innovations. Currently I am doing a Masters in Applied Psychology.
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