Pathologic Findings in Breast Reduction Specimens: Detection of Occult Premalignant and Cancerous Lesions

Abstract

Background: As reduction mammaplasty has become one of the most popular reconstructive procedures, there is an increasing number of reports regarding histopathologic findings in breast tissue yielded by the procedure. Patients and Methods: This study evaluates histopathologic findings in breast tissue removed during reduction mammaplasty procedures performed during a 40-month period (2008–2011), and includes 300 patients of which 258 underwent bilateral breast reduction (group B) and 42 unilateral reduction for symmetry to the contralateral reconstructed breast (group U). Results: Occult carcinomas were detected in 4 (1.55%) group B patients and 1 (2.38%) group U patient. Atypical hyperplasia and intraductal papillomas were identified in 22 (8.6%) and 5 (11.9%) patients, respectively. Benign pathologic changes including typical mild ductal hyperplasia, fibrocystic disease, adenosis, fibroadenoma, and lobular atrophy were identified in 174 (67.44%) group B and 26 (61.9%) group U patients. Conclusion: Breast carcinomas are rarely detected in breast tissue yielded by reduction mammaplasty procedures due to routinely performed preoperative assessment including clinical examination and mammograms. Pathologic examination of specimens provides the clinician with a conclusive diagnosis allowing for possible prompt further management.

Pathology Evaluation of Reduction Mammaplasty Specimens and Subsequent Diagnosis of Malignant Breast Disease: A Claims‐Based Analysis

“…Previous single‐center studies report rates of occult breast carcinoma in reduction mammaplasty specimens to occur 0.4–1.1% of the time [4, 15, 21–26], with slightly higher rates up to 2.4% when patients with a personal history of breast cancer were included in the study cohort [3, 27–29]. Based on the heterogeneity of patient age, inclusion criteria, pathology sampling practices, and sample size of single‐center cohorts, slight differences in the incidence of occult breast cancer found in breast reduction specimens are to be expected.…”

The Prevalence of Fibrocystic Changes of Breast Tissue of Patients who Underwent Reduction Mammoplasty in Rasool-Akram, Firuzgar and Sadr Hospitals during 2007-2012

“…In a recent study Kyriopoulos and colleagues found benign pathologic changes including atypical mild ductal hyperplasia, fibrocystic changes, adenosis, fibro adenoma, and lobularatrophy was found in 67/4% of the patients who underwent bilateral reduction mammoplasty. The prevalence of occult carcinoma was also observed in 1/55% of patients [11]. In another retrospective study by Clark and colleagues incidence of benign and pre-cancerous lesions in breast reduction samples over a period of 5 years was investigated.…”

Prevalence of breast cancer in reduction mammoplasty specimens, in women of African origin: preliminary histology results at Mankweng and Polokwane hospitals

“…Elsewhere breast cancer in reduction mammoplasty specimens has been reported in the literature to vary between 0.1% and 4.5%. (2) The patients usually complain of upper backache, of problems in obtaining brassieres of the correct size and finding clothes that fit. They also complain of difficulties in participating in sports.…”