Histopathologic findings in breast reduction specimens

Abstract

Reduction mammaplasty is a commonly performed operation for treatment of breast hypertrophy. It allows examination of specimens from a seemingly healthy population. Although there are many publications reporting the incidence of occult breast carcinomas, only a few studies have specifically examined the incidence of other breast lesions in reduction mammaplasty specimens. The authors conducted a single-centre retrospective chart review examining the incidence of benign and precancerous lesions in breast reduction specimens. Both age and the number of tissue sections were evaluated for the association with important pathologic findings. Of the 95 patients who underwent reduction mammaplasty, eight patients (8.4%) had atypical lesions. Fourteen patients (15%) had proliferative and 54 patients (57%) had non-proliferative breast lesions. No occult invasive breast cancer was identified in the breast reduction specimens. The existence of significant pathologic findings was not associated with age (p = 0.231, student t-test). On the other hand, it was found to be associated with the number of tissue sections (p = 0.046, Mann-Whitney U-test). This study reveals that breast reduction specimens should be analyzed histologically since a considerable amount of patients have breast lesions with increased cancer risk. Therefore, this analysis would guide the management of these patients in the follow-up period.

Should we routinely analyze reduction mammaplasty specimens?

“…The importance of high-risk lesions for the patients is clear over time. 18 There are some limitations to our study. Because of its retrospective nature, we could not standardize preoperative routines and histopathological sampling.…”

“…It has been reported that routine histopathological analysis of reduction mammaplasty specimens is not costeffective because the incidence of occult cancers in the specimens is low. 1,37 However, as Kececi et al 18 suggested, these figures are usually calculated for individual cancers detected and do not consider risk-increasing findings. Highrisk lesions should be considered in determining whether histopathological analysis of specimens is cost-effective or not.…”

Estudos histopatológicos de mamoplastias redutoras em hospital universitário. Análise de 10 anos

“…Carcinoma invasor foi encontrado em uma (0,25%) peça cirúrgica, de uma mulher de 51 anos submetida a cirurgia unilateral devida a mastectomia contralateral por câncer de mama, estando dentro da prevalência de carcinomas subclínicos (0 a 4%) publicados em outros trabalhos (9,10,11,19,21,23,24). Esta paciente também apresentava alterações proliferativas atípicas.…”

“…Na América Latina o índice de mortalidade por essa doença aumentou nos últimos quarenta anos (22). Em pacientes submetidas a mamoplastia redutora, a frequência de câncer diagnosticada nas peças cirúrgicas retiradas varia entre 0 a 4% (9,10,11,19,21,23,24).…”