Breast lesions in reduction mammaplasty specimens: a histopathological pattern in 534 patients

Abstract

Background: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.Methods:Personal and histopathological data from 534 female patients who underwent RM were reviewed.Results: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.Conclusion: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., patient age, personal history of breast cancer).

The rate of incidental atypical and malignant breast lesions in reduction mammoplasty specimens

“…In our study, the rate of AMBL in patients with no history of breast cancer was 3.3%. The previous studies that included only patients with no history of breast cancer reported the rate of AMBL to be between 1.5 and 14% 5,7–26 . The wide range of reported rates of AMBL in different studies can be attributed to different pathological assessment methods of RM specimens between institutions.…”

“…It is well known that patients with a history of breast cancer have an increased risk of metachronous breast cancer 2–4 . In this context, previous studies that analysed RM specimens showed a higher rate of incidental breast cancer in patients with a history of breast cancer compared to patients with no history of breast cancer 5–11 . The rate of incidental atypical and malignant breast lesions (AMBL) in patients with no history of breast cancer ranged from 1.5 to 14% 5,7–26 .…”

Exame anatomopatológico de rotina em mamoplastia redutora: análise de resultados

“…A incidência de carcinoma oculto em espécimes de mamoplastia redutora varia entre 0,06 a 0,4% em séries históricas populacionais, porém em estudos com séries menores e em centro único essa incidência apresenta grande variabilidade [1][2][3][4]8 . Essa discrepância possivelmente se deve a inclusão de pacientes com diferentes perfis de risco (pacientes com história prévia de neoplasia podem apresentar incidência de câncer oculto de até 4,6%) 9 .…”

“…A ocorrência de carcinoma oculto detectado nos espécimes de mamoplastia redutora tem sido estimada entre 0,06 e 0,4% em séries históricas populacionais [1][2][3] , porém essa porcentagem apresenta tendência de aumento em estudos mais recentes, além de grande variabilidade em estudos com amostras menores e realizadas em centro único 4 . Dessa forma, pode-se depreender que a cirurgia de redução mamária apresenta um risco pequeno, porém definitivo, de revelar carcinoma no tecido ressecado.…”

4. Practical and Ethical Issues in Establishinga Collection of Normal Breast Tissue Biopsies—Part of the NOWACPost-Genome Cohort

“…It is plentiful and removed for cosmetic reasons, not because of clinical abnormalities or high-risk profiles. However, none of these tissues have been found suitable as a substitute for truly normal breast tissue in studies of breast cancer carcinogenesis (Ambaye et al 2009, Graham et al 2010, Degnim et al 2012, Tadler et al 2014, Acevedo et al 2019.…”