Histopathological findings obtained from reduction mammoplasty specimens

Abstract

IntroductionReduction mammoplasty is one of the most commonly performed procedures of plastic surgery. The main physical complaints, secondary to macromastia, include pain in the back, stomach, shoulders, arms, neck, and breasts, and headache, itching, rash, other forms of dermatitis under the breasts, and various paresthesias (1-5). Reduction mammoplasty surgery can also be performed for cosmetic reasons as well as symptomatic causes. In addition to achieving a reduction in the breast volume, breast reduction surgery also enables histopathological investigation of the resected breast tissue, thereby detecting any potential malignant and premalignant lesions, even if the patient does not have any complaints (1,3).Even if only a few specimens are randomly selected and examined among the specimens sent for pathological investigation, a large spectrum of lesions from benign to proliferative lesions, and even malignant ones, can be detected. This trial was designed to retrospectively review the histopathological diagnoses of reduction mammoplasty specimens and to determine the incidence of breast lesions in asymptomatic females. Materials and methodsWe reviewed 106 reduction mammoplasty specimens sent to the Hacettepe University Medical Faculty Pathology Department between 2004 and 2010. We observed that some cases had 2 or more diagnoses. The patients had no symptoms other than macromastia and its associated symptoms. They had applied for cosmetic and reconstructive correction of breast deformities, mostly due to breast hypertrophy.The cases were classified according to age, mean weight of the specimen, number of tissue sections investigated, and pathological findings. The pathological findings were categorized based on the Cancer Committee of the College of American Pathologists consensus established in 1998 (Table 1) (5). The only exception was columnar lesions, which were diagnosed and classified according to Collins and Schnitt (6).Background/aim: Reduction mammoplasty is a common surgical procedure. We report the incidence of nonproliferative and proliferative breast lesions in breast reduction specimens from a single institution over a 6-year period. Materials and methods:The histopathology reports of all patients were analyzed. The clinical and histopathological findings of the patients were recorded.Results: Between 2004 and 2010, 106 patients underwent breast reduction. Fifty-six patients (52.8%) had proliferative breast lesions, 84 patients (79.2%) had nonproliferative lesions, 8 patients (7.5%) had columnar cell lesions without atypia, 61 patients (57.5%) had columnar cell lesions with atypia, 5 patients (4.7%) had atypical ductal hyperplasia, and 6 patients (5.6%) had lobular carcinoma in situ. No invasive breast cancer was identified. Conclusion:In Turkey, there is limited evidence regarding the role of histopathological analysis in reduction mammoplasty. Moreover, none of the previous studies determined columnar cell lesion rates in reduction mammoplasty patients. The detection of significantly elevate...