The Evaluation of Contralateral Breast Lesions in Breast Cancer Patients Using Reduction Mammoplasty (original) (raw)
Related papers
Incidental Lesions Detected in Reduction Mammoplasty Specimens
Indian Journal of Surgery, 2019
The incidence of breast lesions detected in reduction mammoplasty specimens varies with patients' previous history of breast cancer, patients' age, and the number of submitted pathological sections. The incidence of proliferative lesions with atypia including invasive carcinoma varies in different studies between 0.2% and 1.1%. In a retrospective review, 392 patients who underwent reduction mammoplasty mainly for symptomatic macromastia or breast symmetry were included in this study. All specimens of reduction mammoplasty were submitted for pathological examination and at least four tissue sections were taken for each breast. Among 392 patients, pathological examinations revealed proliferative lesions with atypia in 7 patients (1.7%) and invasive carcinoma in 1 patient (0.2%). Although proliferative lesions with atypia were found to increase in number compared with the patients under 40 years, there was no statistical significance found. Ductal in situ carcinoma was demonstrated in 1 patient (1%) younger than 40 years. Although there is no consensus formed for when to send mammoplasty specimens for pathological analysis or how many numbers of tissue sections to submit, we recommend routine pathological analysis of mammoplasty specimens and submitting at least four tissue sections regardless of patients' age.
Breast lesions in reduction mammaplasty specimens: a histopathological pattern in 534 patients
British journal of cancer, 2014
The prevalence of breast lesions (benign, precancerous and cancer lesions) in reduction mammaplasty (RM) specimens has rarely been reported in Europe and never in the Swiss population. Personal and histopathological data from 534 female patients who underwent RM were reviewed. Benign and/or malignant lesions were detected in 76.2% of all patients. Benign breast lesions associated with an increased risk of developing breast cancer represented 2.8% of all lesions. Breast cancer in situ was identified in 5 (0.9%) patients. Patient age and previous history of breast cancer were risk factors for incidental breast cancer. The rate of incidental carcinoma in situ was higher for patients with breast cancer history. Probably due to preoperative breast cancer investigation, no occult invasive breast cancer was found in reduction mammary specimens. Therefore before RM, breast cancer evaluation should be considered for all patients, especially for those with breast cancer risk factors (e.g., pa...
Breast Cancer Research and Treatment, 2019
Introduction Bilateral reduction mammoplasty is one of the most common plastic surgery procedures performed in the U.S. This study examines the incidence, management, and prognosis of incidental breast cancer identified in reduction specimens from a large cohort of reduction mammoplasty patients. Methods Breast pathology reports were retrospectively reviewed for evidence of incidental cancers in bilateral reduction mammoplasty specimens from five institutions between 1990 and 2017. Results A total of 4804 women met the inclusion criteria of this study; incidental cancer was identified in 45 breasts of 39 (0.8%) patients. Six patients (15%) had bilateral cancer. Overall, the maximum diagnosis by breast was 16 invasive cancers and 29 ductal carcinomas in situs. Thirty-three patients had unilateral cancer, 15 (45.5%) of which had high-risk lesions in the contralateral breast. Twenty-one patients underwent mastectomy (12 bilateral and nine unilateral), residual cancer was found in 10 in 25 (40%) therapeutic mastectomies. Seven patients did not undergo mastectomy received breast radiation. The median follow-up was 92 months. No local recurrences were observed in the patients undergoing mastectomy or radiation. Three of 11 (27%) patients who did not undergo mastectomy or radiation developed a local recurrence. The overall survival rate was 87.2% and disease-free survival was 82.1%. Conclusions Patients undergoing reduction mammoplasty for macromastia have a small but definite risk of incidental breast cancer. The high rate of bilateral cancer, contralateral high-risk lesions, and residual disease at mastectomy mandates thorough pathologic evaluation and careful follow-up of these patients. Mastectomy or breast radiation is recommended for local control given the high likelihood of local recurrence without either. Keywords Reduction mammoplasties • Incidental cancer • Breast cancer • High-risk breast lesions Rong Tang and Francisco Acevedo are the co-first authors.
Occult Breast Carcinoma in Reduction Mammaplasty Specimens: 14-Year Experience
Plastic and Reconstructive Surgery, 2004
Reduction mammaplasty is commonly performed for bilateral macromastia, congenital asymmetry, or as a contralateral symmetry procedure in breast reconstruction following mastectomy for cancer. Occult carcinoma has been detected in 0.06 percent to 0.4 percent of breast reduction specimens. The purpose of this study was to examine the incidence of breast cancer in breast reductions performed in one institution over a 14-year period. The authors reviewed their experience with 800 reduction mammaplasties performed between 1988 and 2001. Six cancers were detected (0.8 percent). Of these cancers, three were invasive (0.4 percent) and three were ductal carcinoma in situ (0.4 percent). Stratified by indication for surgery, there was a trend toward higher detection rates in the reconstruction group (1.2 percent) compared with the macromastia (0.7 percent) or congenital asymmetry (0 percent) groups. Mammography was performed preoperatively in these patients and all results were negative for masses or suspicious microcalcification. Pathological diagnosis was guided by gross specimen evaluation in two patients and specimen radiography in one patient. Reduction mammaplasty has a small but definite risk of finding cancer in the resection specimen. (Plast.
Breast cancer research and treatment, 2018
Mammoplasty removes random samples of breast tissue from asymptomatic women providing a unique method for evaluating background prevalence of breast pathology in normal population. Our goal was to identify the rate of atypical breast lesions and cancers in women of various ages in the largest mammoplasty cohort reported to date. We analyzed pathologic reports from patients undergoing bilateral mammoplasty, using natural language processing algorithm, verified by human review. Patients with a prior history of breast cancer or atypia were excluded. A total of 4775 patients were deemed eligible. Median age was 40 (range 13-86) and was higher in patients with any incidental finding compared to patients with normal reports (52 vs. 39 years, p = 0.0001). Pathological findings were detected in 7.06% (337) of procedures. Benign high-risk lesions were found in 299 patients (6.26%). Invasive carcinoma and ductal carcinoma in situ were detected in 15 (0.31%) and 23 (0.48%) patients, respective...
Approach to histopathological incidental lesions after reduction mammoplasty
European Journal of Plastic Surgery, 2019
Background The importance of analyzing tissue removed during reduction mammoplasty in healthy and asymptomatic patients has been emphasized in many publications. Pathological analysis can reveal many important findings that may be used to determine the patient's risk of breast cancer. Methods The pathology findings of patients who underwent reduction mammoplasty and mastopexy due to breast asymmetry and/or breast hypertrophy between January 1995 and May 2018 were analyzed retrospectively. Results A total of 283 women underwent breast reduction during the study period (560 breasts). Of all of the specimens, 273 had histopathological findings, most of which were fibrocystic breast tissue pattern (85.71%). In 11 specimens, 16 lesions considered proliferative in nature were detected. The mean follow-up period of the proliferative lesions was 6.1 years. No malignancy was observed during the follow-up period. Conclusions Age is not the only significant factor affecting pathology results. Risk factors should be determined and imaging findings should be considered as well. Every reduction mammoplasty procedure should be regarded as an opportunity for screening the breast tissue of the candidates. Level of evidence: Level IV, risk/prognostic study.
Histologic Profiles of Breast Reduction Specimens
Aesthetic Plastic Surgery, 2002
Reduction mammaplasty is one of the most common procedures performed by plastic surgeons all around the world. This procedure is performed for aesthetic or reconstructive purposes, but also offers the opportunity to examine all resected breast tissue histopathologically. The purpose of this study was to evaluate the histologic diagnoses of the reduction mammaplasty specimens retrospectively and to determine the incidence of breast lesions in otherwise asymptomatic and healthy women. Therefore, 149 patients who had undergone reduction mammaplasty were reviewed with regard to their histologic diagnoses. We found that 61% of these women have pathologic alterations in at least one of their breasts, so each patient who requests a breast reduction surgery should be evaluated carefully and the specimens should be handled with particular care.
Is Histological Evaluation of Reduction Mammaplasty Specimens Worthwhile?
Aesthetic Surgery Journal, 2018
Background: Reduction mammaplasty (RM) is one of the most common plastic surgery procedures. Despite its cost, the total number of RM procedures continues to increase every year. Objectives: The purpose of this study is to review the prevalence of benign and malignant breast lesions among women who live in the Aegean region of Turkey, based on our university hospital's records and to compare our results with those in the literature. Methods: Seven hundred and thirty-three consecutive female patients who underwent RM between January 2003 and January 2017 in the Department of Plastic, Reconstructive, and Aesthetic Surgery were included in this study. Results: One hundred and sixty-five patients (23.4%) had preoperative breast imaging results. According to the Breast Imaging Reporting and Data System (BIRADS), most of these patients had BI-RADS-2 and BIRADS-1 findings (41.21% and 40%, respectively). Fibrocystic changes were the most common lesions (81.3%). Sixty-eight patients (9.6%) had normal breast tissue on the right side and 34 patients (4.8%) had the same on the left side. Five patients (0.71%) had atypical ductal hyperplasia and no atypical lobular carcinoma. Four patients (0.56%) had occult breast cancer and one patient (0.14%) had benign phyllodes tumor. Conclusions: RM is a good opportunity to detect proliferative lesions and occult breast cancer. While meeting the patient's aesthetic desires, the plastic surgeon should consider for histopathological evaluation. We suggest that every part of the breast tissue should be sent to pathological examination regardless of the weight of the specimen. Even if health insurance does not cover its cost, patients should be informed about the importance of this process.
Contralateral Breast Cancer in Women with Early Stage Breast Cancer
2015
The rate of contralateral breast cancer in women with early stage breast cancer is uncertain. In order to determine this rate, a systematic review and meta analysis was conducted. The rate of contralateral breast cancer in women with early stage breast cancer was found to be 0.36% per year. This rate appears to be constant for up to 10 years after the original breast cancer diagnosis. This data is important for women with breast cancer and their healthcare teams in order to make decisions about bilateral mastectomy.
Mammographic Findings Following Reduction Mammoplasty
Aesthetic Plastic Surgery, 2001
Breast reduction mammoplasty is becoming an increasingly common procedure. A baseline mammogram is recommended after 35 years of age as the most effective method for detection of small breast cancers. A prospective study was conducted for the evaluation of the mammographic findings after reduction mammoplasty. During the last 7 years, 113 patients over 35 years of age underwent bilateral reduction mammoplasty. All patients had a preoperative mammogram. A new mammogram was obtained at 6 and 18 months after the procedure. All films were reviewed by the same two radiologists. Breast reduction was performed with the vertical bipedicle flap technique (McKissock) and the inferior pedicle technique. There were no apparent differences in the findings between the two methods. Most common findings were parenchymal redistribution in 102 (90.2%) and elevation of the nipple in 96 (84.9%), produced by a shift of the breast tissue to a lower position. Calcifications were seen in 29 (25.6%), and "oil cysts" in 22 (19.4%), caused by localized fat necrosis. A retroareolar fibrotic band was found in 23 (20.3%), from the transposed flap. Areolar thickening was observed in six (5.3%), and skin thickening in only two (1.7%), from scar tissue. Mammographic findings after reduction mammoplasty are predictable, thus preventing unnecessary biopsies and making the diagnosis of lesions unrelated to the procedure easier. All patients over 35 years of age should have a preoperative and a postoperative mammogram for future reference.