Clinical and basic research of implantation of free dermal fat graft for breast cancer patients

• Project/Area Number: 16K10465
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: General surgery
• Research Institution: Fujita Health University (2018); Kagoshima University (2016-2017)
• Principal Investigator: Kijima Yuko 藤田医科大学, 医学部, 教授 (60381175)
• Co-Investigator(Kenkyū-buntansha): 平田 宗嗣 鹿児島大学, 附属病院, 医員 (00649072) ; 中条 哲浩 鹿児島大学, 医歯学域附属病院, 講師 (20404486) ; 新田 吉陽 鹿児島大学, 附属病院, 医員 (20725733) ; 夏越 祥次 鹿児島大学, 医歯学域医学系, 教授 (70237577) ; 有馬 豪男 鹿児島大学, 医歯学域附属病院, 助教 (90418856)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000); Fiscal Year 2018: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000); Fiscal Year 2016: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
• Keywords: 乳癌 / 乳房温存手術 / 整容性 / 遊離真皮脂肪片 / 乳房縮小手術 / 乳房温存術 / 外科治療 / オンコプラスティックサージャリー / オンコプラスティックサージェリー / *乳癌

Outline of Final Research Achievements

We implanted FDFG for patients with early breast cancer on upper-inner quadrant area indicative for breast conserving surgery followed by immediate breast reshaping using FDFG. According our former research (Kijima Y, et al. JPRAS 2007)(Kijima Y, et al. Gland Surgery 2015), caused of perioperative complications resulted in those two factors. First is host factor (smoking) and a clinical factor (experience of the practiced hand, operative time, intraoperative bleeding, size of the free dermal fat graft, resected breast size). In clinical practice, we selected adequate patients for breast conserving surgery followed by immediate FDFG implantation. So that, it was difficult to find out any patients group adequate for FDFG with CAL or platelet. On the other hand, it became clear that volume replacement for patients without ptotic breasts using FDFG or thoracodorsal adipofascial cutaneous flap, and volume displacement for patients with ptotic breasts are also useful for Japanese patients.

Academic Significance and Societal Importance of the Research Achievements

対象症例での周術期合併症について，多施設共同研究では周術期合併症のリスクファクターとして宿主因子（喫煙）および臨床因子（術者の経験，手術時間，術中出血量，移植片のサイズ，摘出乳腺サイズ）があげられた（Kijima et al. Gland Surgery 2015）.実臨床ではこれらの明らかになったリスクを回避した症例を抽出して患者選を行ったため本手技による優越性を見出すことは困難であった．.同時期に実施した整容性を考慮した乳房温存術時の手術介入については，乳房下垂の有無別に実施したvolume replacement，volume displacementが有用であることが明らかとなった．

Research Products

• [Journal Article] Oncoplastic breast surgery combining partial mastectomy with immediate breast reshaping using multiple local flaps for a patient with slim body (2019)
  • Author(s): Kijima Yuko、Hirata Munetsugu、Shinden Yoshiaki、Utsumi Toshiaki、Morise Zenichi、Natsugoe Shoji
  • Journal Title: Breast Cancer Volume: @ Issue: 4 Pages: 529-534
  • DOI: 10.1007/s12282-019-00948-5
  • Peer Reviewed
• [Journal Article] Molecular pathogenesis of triple-negative breast cancer based on microRNA expression signatures: antitumor miR-204-5p targets AP1S3. (2018)
  • Author(s): Toda H, Kurozumi S, Kijima Y, Idichi T, Shinden Y, Yamada Y, Arai T, Maemura K, Fujii T, Horiguchi J, Natsugoe S, Seki N.
  • Journal Title: J Hum Genet Volume: 63(12) Issue: 12 Pages: 1197-1210
  • DOI: 10.1038/s10038-018-0510-3
  • Peer Reviewed
• [Journal Article] Clinical experiences for oncoplastic breast surgery improve a cosmetic outcome and reduce postoperative complications (2018)
  • Author(s): Kijima Y, Hirata M, Shinden Y, Utsumi T, Morise Z, Natsugoe S.
  • Journal Title: Clinics in Surgery Volume: 3 Pages: 20145-20145
  • Peer Reviewed
• [Journal Article] Apocrine papillary lesion: comparison of pathological findings from 22?years previously and the present (2018)
  • Author(s): Nomoto Yuki、Yoshinaka Heiji、Ohi Yasuyo、Hayashi Naoki、Nagata Ayako、Sueyoshi Kazunobu、Eguchi Yuka、Shinden Yoshiaki、Kijima Yuko、Natsugoe Shoji
  • Journal Title: Breast Cancer Volume: @ Issue: 4 Pages: 524-528
  • DOI: 10.1007/s12282-018-00936-1
  • Peer Reviewed
• [Journal Article] Two cases of radiation-associated angiosarcoma of the breast (2018)
  • Author(s): Nomoto Yuki、Kijima Yuko、Shinden Yoshiaki、Hirata Munetugu、Eguchi Yuka、Yoshinaka Heiji、Kitazono Ikumi、Hiraki Tsubasa、Tanimoto Akihide、Natsugoe Shoji
  • Journal Title: Surgical Case Reports Volume: 4 Issue: 1
  • DOI: 10.1186/s40792-018-0539-8
  • Peer Reviewed
• [Presentation] 脂肪筋膜弁を用いた乳房温存術時の一次欠損部補填法（volume replacement）の後ろ向き検討 (2018)
  • Author(s): 喜島祐子，新田吉陽，江口裕可，中条哲浩，田上聖徳，平田宗嗣，吉中平次，夏越祥次
  • Organizer: 第118回日本外科学会総会
• [Presentation] 乳房縮小手技を導入したOncoplastic breast surgery（１施設での10年間の結果報告） (2018)
  • Author(s): 喜島祐子，新田吉陽，江口裕可，野元優貴，中条哲浩，田上聖徳，林直樹，平田宗嗣，吉中平次，夏越祥次．
  • Organizer: 第26回日本乳癌学会学術総会
• [Presentation] E領域乳癌に対するOncoplastic Breast Surgery． (2018)
  • Author(s): 喜島祐子，新田吉陽，江口裕可，野元優貴，平田宗嗣，吉中平次，夏越祥次
  • Organizer: 第6回日本乳房オンコプラスティックサージャリー学会
• [Presentation] Oncoplastic Breast Surgery in Japanese experience - Volume Replacement and Displacement Surgery- (2018)
  • Author(s): Yuko Kijima
  • Organizer: Taiwan Oncoplastic Breast Surgery Society 2018 Annual Meeting
  • Int'l Joint Research / Invited
• [Presentation] Video presentation, Oncoplastic Breast Surgery (2018)
  • Author(s): Yuko Kijima
  • Organizer: Taiwan Oncoplastic Breast Surgery Society 2018 Annual Meeting
  • Int'l Joint Research / Invited