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Comment & Response
March 13, 2019

Body Mass Index as a Potential Confounder for Oncological Outcomes Following Autologous Fat Transfer—Reply

Author Affiliations
  • 1Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center+, Maastricht, the Netherlands
  • 2Department of Plastic, Reconstructive and Hand Surgery, Tergooi Hospital, Hilversum, the Netherlands
JAMA Surg. 2019;154(6):566-567. doi:10.1001/jamasurg.2019.0118

In Reply We have carefully read the comments of Quinn et al regarding our recently published article.1 The authors propose that body mass index (BMI) could be a potential confounder to account for the differences in mortality found in our study.

Although we are aware of the large number of factors involved in the etiology of breast cancer, our study focused mainly on surgical and histopathological parameters used by our multidisciplinary team to determine the prognosis and oncological treatment of each patient. Therefore, data were retrieved from surgical, pathological, radiological, and plastic surgical documentation in the patient records. In addition, we consulted national oncological and histopathological databases to perform additional screening for oncological events in patients receiving oncological follow-up elsewhere (referrals). Unfortunately, BMI, other comorbidities, lifestyle, environmental, and psychosocial factors were not readily available, as they required additional screening of nursing and anesthesiological records.

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