Should We Be Analysing Breast Reduction Specimens? A Systematic Analysis of Over 1,000 Consecutive Cases

Hassan, Faiza E.; Pacifico, Marc D.

doi:10.1007/s00266-012-9919-9

Cited by 33 publications

(37 citation statements)

References 36 publications

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“…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.…”

Section: Discussionmentioning

confidence: 98%

“…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 .…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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Aims: Reduction mammoplasty (RM) is one of the most common plastic surgeries in the United States. We aimed to demonstrate the rate of incidental atypical and malignant breast lesions (AMBL) found in RM specimens and the impact of the number of submitted tissue sections on the rate of AMBL. Methods and results: We analysed our database for patients who had undergone reduction mammoplasty between 2000 and 2018. Patients with a history of breast cancer were excluded from the study. All pathology reports were analysed for AMBL (ALH, LCIS, FEA, ADH, DCIS, invasive carcinoma). The grossing protocol was to submit 10 sections from each breast between 2000 and 2013 and six sections between 2014 and 2018. One hundred and sixtynine of 5208 patients (3.3%) and 216 of 10 340 RM specimens (2.1%) showed at least one AMBL. Nineteen (0.36%) patients had incidental cancer. The median age of patients with AMBL was significantly higher than patients without ABL (aged 59 years versus 45 years). There was no cancer in patients aged <30 years. The age-controlled rate of overall AMBL as well as atypia and cancer only did not decrease by submitting fewer sections during the 2014-18 period compared to the 2010-13 period. Conclusions: Decreasing the number of tissue sections from 10 to six did not lead to a significant decrease in the rate of overall AMBL or cancer. Our data suggest that submitting six tissue sections from each breast for patients aged >30 years and two sections from each breast for patients aged <30 years would be sufficient.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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“…It is proposed that routine histologic examination of the reduction mammaplasty specimens are not cost-effective since the incidence of occult carcinoma in reduction mammaplasty patients is low, and that histological analysis of specimens should be restricted to high-risk patients and those over 30 years of age [24,25]. However, these authors did not take the breast lesions with elevated cancer risks into account when they calculated the price of histologic examination of reduction mammaplasty specimens.…”

Section: Discussionmentioning

confidence: 99%

Histopathologic findings in breast reduction specimens

Keçeci¹,

Taşlı²,

Yağcı³

et al. 2013

Journal of Plastic Surgery and Hand Surgery

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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.

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“…Our results are within the higher end of the range reported in previous studies (2-13), which in part may be explained due to inclusion of in situ carcinomas in our study. In some studies, for example, LCIS results are not included in the cancer findings (6). There has been a debate concerning the role of LCIS as a precursor for breast cancer.…”

Section: Discussionmentioning

confidence: 99%

“…The highest incidences are from institutional studies (2,3), and the lowest are from large population-based studies (4,5). A literature review by Hassan and Pacifico (6), however, demonstrated variations in study methodologies, inclusion of in situ carcinomas, and what is defined as a relevant breast pathology finding. This discrepancy makes studies difficult to compare.…”

Section: Introductionmentioning

confidence: 99%

Adverse Histopathology and Imaging Findings in Reduction Mammaplasty Day-surgery Patients

et al. 2014

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Background and Aims: reduction mammaplasty is a popular procedure in plastic surgery. occasionally, occult invasive breast carcinoma or findings demonstrating increased risk of breast cancer occur in reduction mammaplasty specimens. the incidences have been studied elsewhere, but in Finland, the data on this subject are lacking. our aim was to analyze the incidence of occult invasive and in situ carcinoma and benign breast disease causing increased risk of breast cancer in reduction mammaplasty specimens. We also analyzed preoperative mammograms and ultrasound images and compared findings with reduction mammaplasty specimens.Material and Methods: We performed a retrospective study of 100 women who underwent reduction mammaplasty during 1 January 2007 to 30 April 2009 in Jorvi Hospital day-surgery unit. demographic data, findings in preoperative imaging, pathology reports, postoperative follow-up, and retrospective reanalysis of preoperative imaging were recorded.Results: Histological abnormality occurred in 14.6% of the patients. in situ carcinoma was diagnosed in 4.5% of the patients, and findings demonstrating increased risk of breast cancer were diagnosed in 13.5% of the patients. more than one lesion demonstrating increased risk of breast cancer was diagnosed in 4.5% of the patients. no invasive carcinoma occurred. preoperative mammogram was performed for the majority (94.0%) of the patients.Conclusions: We detected a considerable amount of findings in reduction mammaplasty specimens with prognostic value with regard to future breast cancer risk. We recommend

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Should We Be Analysing Breast Reduction Specimens? A Systematic Analysis of Over 1,000 Consecutive Cases

Abstract: This journal requires that authors assign a level of evidence to each article.

Cited by 33 publications

References 36 publications

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

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

Histopathologic findings in breast reduction specimens

Adverse Histopathology and Imaging Findings in Reduction Mammaplasty Day-surgery Patients

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