Can I still have breast cancer screening after breast fat transfer?

This is a question people considering breast fat transfer always ask: “Won’t it cause problems with breast cancer screening later?” Here is why people worry. Some of the transferred fat that doesn’t survive can remain as oil pockets (oil cysts) or small calcifications, and on a mammogram, calcifications can also be a clue for finding cancer.

How often do they actually show up? A 2011 French study that reviewed mammograms of people who had breast fat transfer found microcalcifications in 16%, large calcifications in 9% and well-defined cysts in 25%. But breast density and the reading category (BI-RADS) didn’t change significantly compared with before surgery. The researchers concluded that the changes did not interfere with follow-up imaging.

Then can these changes be told apart from cancer? A 2012 US study answers this question most directly. Mammograms taken 1 year after cosmetic breast fat transfer in 27 people were mixed with mammograms of 23 people who had breast reduction, and 8 breast radiologists at a university hospital read them without knowing which surgery each person had had. There was no difference between the two groups in oil cysts, benign calcifications or calcifications needing a biopsy, and scar changes and masses needing a biopsy were actually more common after breast reduction. It’s also worth noting that in this study, a cell component was added to the fat. Breast reduction has long been accepted as a surgery that doesn’t cause problems with screening.

It’s not all good news. A 2016 review of 43 studies (6,260 people) that used fat transfer for reconstruction after breast cancer surgery found that 3.7% needed a biopsy because of imaging findings, higher than the 1.6% for other breast surgery. The researchers concluded that whether fat transfer interferes with follow-up imaging still needs more study. Keep in mind that these data come from reconstruction after cancer surgery, not cosmetic procedures.

So I recommend three things. Have a recent breast screening before surgery so there are baseline images on record. After surgery, keep having screening on your usual schedule. And at each screening, be sure to mention that you’ve had breast fat transfer, and when. When the doctor reading your images knows this, it’s much easier to tell changes from fat transfer apart from new changes. To reduce oil cysts, what matters most is placing the fat in thin strands from the start so that more of it survives.