Mammoplasty for symmetry in breast reconstruction and histologic assessment

Abstract

Background:In breast reconstruction, complementary surgery on the contralateral breast is sometimes necessary to obtain a satisfactory aesthetic result. This complementary mammoplasty for symmetry gives the surgeon the opportunity to verify the state of the mammary glandular tissue to rule out a possible occult tumour in the contralateral breast. Our objective was to determine the prevalence of borderline lesions and of in situ and invasive carcinoma in specimens of the contralateral breast in a mammoplasty for symmetry in patients with breast cancer. Methods:We conducted a retrospective study of 145 breast reconstructions with mammoplasty for symmetry conducted at the Tours Regional Teaching Hospital in France. Results:The glandular histologic result after mammoplasty was normal in 45.5% of patients, with benign pathologies in 38.9% and borderline lesions in 15.6% of patients. No invasive or in situ carcinoma was detected. Conclusion:Systematic histologic analysis of glandular mammary tissue sampled after reduction mammoplasty in the particular context of breast reconstruction after breast cancer makes it possible to discover lesions that were not seen in presurgical evaluation. The early management of these borderline occult lesions could reduce the incidence of breast cancer in these at-risk patients.Contexte : Les reconstructions mammaires nécessitent parfois un geste complémen-taire sur le sein controlatéral pour un résultat esthétique satisfaisant. Cette chirurgie de symétrisation a l'avantage de donner l'opportunité au chirurgien d'analyser l'état du tissu glandulaire pour éliminer une éventuelle tumeur controlatérale occulte. Notre but était de déterminer la prévalence des lésions frontières, des cancers in situ et invasifs dans les spécimens de plasties mammaires de symétrisation chez les patientes atteintes de cancer du sein.Méthodes : Nous avons étudié rétrospectivement 145 reconstructions mammaires avec une plastie mammaire de symétrisation réalisée au centre hospitalier régional et universitaire de Tours.

The Effects of Breast Size in Unilateral Postmastectomy Breast Reconstruction

“…Several studies have investigated the benefits of contralateral mammaplasty in large-breasted women both for obtaining symmetry and for histologic investigation of occult carcinoma. 24,25 The significant differences in patterns of contralateral symmetry procedure underscore its importance as a driving factor in terms of averaging out the extremes of breast size when it comes to choosing reconstructive options.…”

Histopathological findings obtained from reduction mammoplasty specimens

“…Our incidence of ADH is slightly higher compared with previous reports. However, Horo et al assessed 145 reduction mammoplasties and reported borderline lesions (ADH) in 12 (15.6%) of the patients (15).…”