The cover of the November print edition of Wired fea­tures large, unnatural-​​appearing cleavage. Inside and toward the back of the issue, a curious article ties together stem cells and the future of breast recon­struction. It got my attention.

Wired, November 2010 issue

The detailed and admit­tedly inter­esting piece, by Sharon Begley, describes what’s science or science fiction: first humans, such as some plastic sur­geons, remove adipose tissue, a.k.a. fat, by a well-​​established cos­metic surgery pro­cedure called lipo­suction, from a body part where there’s a fat surplus — such as the belly or backside; next, lab­o­ratory workers purify and grow what are said to be stem cells from that that fat; finally, they use a nifty, cal­i­brated and expensive device to inject those fatty stem cells where women want, such as in a hole or dimpled breast where a tumor’s been removed.

The story starts, unfor­tu­nately and dis­tract­ingly, with a por­trait of a male, enter­prising and Pow­er­Point presentation-​​giving CEO of a biotech company, Cytori Ther­a­peutics. Toward the end of the article, the author pro­vides stats to support the potential business. Ulti­mately, improved breast cancer sur­vival means that greater numbers of women will live more years after a lumpectomy or mas­tectomy, she explains. The recon­struction market may expand further, still, because some women opt for pro­phy­lactic mas­tec­tomies upon pos­itive genetic testing for a BRCA mutation. Others, without cancer or high risk, might simply want to use these adipose-​​derived stem cells for cos­metic breast aug­men­tation. What’s clear, if nothing else, is that women’s breasts are per­ceived as a commodity.

In between the money ele­ments of the dis­cussion, there’s some cool science about adipose-​​derived stem cells, which according to the cited sci­en­tists are quite prevalent in fatty tissue and rel­a­tively easy to grow if you give them some blood to feed on in the lab. A putative advantage of the cells is that they draw blood vessels to the area of engraftment, which is a concern to this oncol­ogist (me) and, evi­dently, to an FDA panel that has not yet approved of this inno­v­ative method of breast recon­struction in women who’ve had breast tumors.

I’m not con­vinced, at least from what’s reported in this Wired article, that the cells used in this process are true stem cells, based on the high numbers the sci­en­tists describe finding so readily, and in rich pro­por­tions, in human fat tissues. It could be, for example, that what they’re iso­lating are really prim­itive adipose cells that can, indeed blend into the breast tissue and even recruit blood vessels as described, but aren’t true, pluripotent stem cells – the kind that can form any kind of blood cell or heart cell or neuron. Perhaps stem cells just sound sexy, at least to investors.